Septic thrombophlebitis is an infection that can occur after the placement of special catheters in your veins. These catheters are used for treatment, but they can also lead to complications.

There are many medical conditions and treatments that require intravenous (IV) medications. Whether you can’t take a medication by mouth or the medication isn’t available in an oral form, IVs are commonplace in the hospital setting.

Peripheral IVs placed in the superficial veins of the arms or hands are usually sufficient, but there are some cases where larger, more invasive lines are needed. This can lead to complications, such as septic thrombophlebitis.

This article will explore why this complication happens, what symptoms you may notice, and how your healthcare team may address the problem.

Septic thrombophlebitis is a complication that can happen, usually after the placement of an invasive line for medical treatment.

Anytime a foreign object — including a line used to deliver medication or other treatments — is inserted into your body, there’s a chance that you can develop a blood clot around that object.

Intravenous catheters are placed directly into your vein, with blood flowing around them. This makes intravenous lines a prime target for blood clot formation.

Inflammation and infection can also occur. Bacteria or fungi can be introduced during the placement of the catheter, or they may already be present in your body. When this inflammation and infection occur alongside the formation of a blood clot, septic thrombophlebitis is the result.

You might not notice the symptoms of septic thrombophlebitis right away. If you’re receiving medications or treatments through an invasive line like a central line or PICC line, your healthcare team may be monitoring for complications. These may include blood clots and infection.

The most common symptoms of septic thrombophlebitis include:

  • fever
  • changes in your white blood cell levels
  • bacterial growth in blood samples (a positive blood culture)

The cause of septic thrombophlebitis is really a perfect storm of various natural body reactions.

Your immune system reacts with inflammation and blood clotting when infection or injury occurs. It can’t differentiate between a traumatic puncture with a foreign object and a planned placement of a large catheter.

For this reason, invasive line placement can cause increased blood clotting and inflammation in blood vessels. Bacteria can also be introduced during placement of the line or make its way into your body through the catheter and its ports after placement.

Why would I need a central line?

Central lines are used in people who are seriously ill and require things like:

  • direct monitoring of blood flow and pressures
  • delivery or medications that would damage or irritate smaller veins
  • emergency intravenous access
  • administration of a large number of, or large volumes of fluids and medications

These lines are placed under sterile precautions and require special management to prevent infections. Infections that develop after central line placement are often referred to as central-line-associated bloodstream infections (CLABSI). Roughly 250,000 CLABSIs develop in the United States each year, usually within 48 hours of initial placement.

Your healthcare team will weigh your specific risks and benefits when discussing the placement of a central or invasive line. In many cases, the medical needs that lead to central line placement outweigh the risk of a possible infection.

Was this helpful?

Sepsis is a catastrophic immune response that happens when you develop a systemic (body-wide) infection.

This condition usually develops from bloodstream or other severe infections that trigger a cascade of immune responses in your body. These immune responses can lead to life threatening illness that is considered a medical emergency.

Septic thrombophlebitis is similar to sepsis in that it develops as a result of the body’s immune response to an infectious organism.

However, septic thrombophlebitis can potentially be treated and controlled before progressing to systemic sepsis.

Treating septic thrombophlebitis requires two distinct strategies.

First, your healthcare team may try to determine the specific infectious organism causing the problem and prescribe antibiotics or antifungal medications to best treat that infection. The development of septic thrombophlebitis may also mean that your intravenous catheter, PICC, or central line needs to be removed.

The second part of treating this problem is to dissolve the blood clot. Your doctor will prescribe specific medications to thin your blood and dissolve the clot.

How long does treatment take for this?

Total treatment of septic thrombophlebitis can take anywhere from a few days to several weeks.

In some cases, you may need to continue taking antibiotics and anticoagulation medication for some time after the initial infection.

In rare cases, extensive infection or clotting may require surgical intervention. Portions of your veins or the clot itself may be removed surgically in order to prevent more serious complications like heart attack, stroke, and systemic sepsis.

Septic thrombophlebitis is a rare complication that can happen when large catheters are placed in your veins. These catheters, like an IV, are used to provide critical treatments or medications, but they carry certain risks.

Your healthcare team will likely review the risks versus the benefits for your specific situation before placing one of these lines, and specific precautions will be taken before and after the line is placed to try and prevent blood clots or infection.