%0 Journal Article
%T Catheter-related septic thrombophlebitis of the great central veins successfully treated with low-dose streptokinase thrombolysis and antimicrobials
%A Patricia Volkow
%A Patricia Cornejo-Ju¨˘rez
%A Ana Arizpe-Bravo
%A Jorge Garc¨Şa-M¨Śndez
%A Enrique Baltazares-Lipp
%A Rogelio P¨Śrez-Padilla
%J Thrombosis Journal
%D 2005
%I BioMed Central
%R 10.1186/1477-9560-3-11
%X We describe three patients with cancer and septic thrombophlebitis of central veins caused by Staphylococcus aureus treated with catheter removal, thrombolysis, and intravenous (IV) antibiotics. In our reported cases, an initial bolus of 250,000 international units (IU) of streptokinase administered during the first h followed by an infusion of 20,000¨C40,000 IU/h for 24¨C36 h through a proximal peripheral vein was sufficient to dissolve the thrombus. After thrombolyisis and parenteral antibiotic for 4¨C6 weeks the septic thrombosis due to Staphylococcus aureus solved in all cases. No surgical procedure was needed, and potential placement of a catheter in the same vein was permitted.Thrombolysis with streptokinase solved symptoms, cured infection, prevented embolus, and in all cases achieved complete thrombus lysis, avoiding permanent central-vein occlusion.Septic thrombophlebitis is an iatrogenic life-threatening disease associated with use of central venous devices and intravenous (IV) therapy. [1-3] Sole use of antimicrobials is rarely effective for controlling infection, requiring removal of the device and anticoagulation but in some cases a more aggressive approach such as resection of the affected vein [2,4-7] or trombectomy is needed [8]. Vein resection or surgical thrombectomy is time-consuming in large central venous lines, has a high rate of complications, can delay administration of chemotherapy, and therefore delay or impede tumor control. Experience with thrombolysis has been published for catheter-related thrombosis [9-13] but for septic thrombosis, this experience is scarce. [14,15] Herein, we describe three women with cancer and septic thrombophlebitis due to Staphylococcus aureus methicillin sensitive, who failed to resolve with catheter removal, parenteral antibiotics, and anticoagulation therapy and who were successfully treated with low-dose streptokinase fibrinolysis. All patients were receiving chemotherapy through non-tunneled polyurethane, singl
%U http://www.thrombosisjournal.com/content/3/1/11