Management and outcomes of pediatric septic thrombophlebitis: a case series

Pediatr Hematol Oncol. 2020 May;37(4):344-352. doi: 10.1080/08880018.2020.1733147. Epub 2020 Mar 6.

Abstract

Septic thrombophlebitis is a potentially life-threatening condition. Pediatric hematologists are often consulted to provide recommendations regarding anticoagulation management. We conducted a ten-year retrospective, single-center study of hospitalized pediatric patients who were treated for septic thrombophlebitis. Our primary outcome was resolution of thrombophlebitis. Twenty-eight patients were included in the study. Eighty-nine percent of patients received both antibiotic and anticoagulation therapy. The median durations of intravenous and total antibiotic therapy were 47.5 days (range 14-120) and 65 days (range 14-281), respectively, and median duration of anticoagulation therapy was 92 days (range 41-268). Resolution of thrombosis defined by magnetic resonance imaging, computed tomography, or ultrasound imaging was documented in 16 of 28 (57%) patients. Despite the high rate of persistent thrombosis, there was a low risk of relapse of infection in cases where antibiotic and/or anticoagulation was discontinued prior to complete resolution of the thrombus. Further research is needed to determine if duration of antibiotic and/or anticoagulation treatment can be shortened.

Keywords: Anticoagulation; Lemierre’s syndrome; septic thrombophlebitis.

Publication types

  • Clinical Trial
  • Video-Audio Media

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Magnetic Resonance Imaging*
  • Male
  • Retrospective Studies
  • Thrombophlebitis* / diagnostic imaging
  • Thrombophlebitis* / drug therapy
  • Ultrasonography

Substances

  • Anti-Bacterial Agents
  • Anticoagulants