Published
http://www.merck.com/pubs/mmanual/section16/chapter212/212g.htm
Septic phlebitis is possible whenever a septic process is present in the extremity distal to or at the level of the venous obstruction. Septic thrombi may form separately from the infectious focus or may occur in contiguity with the inflammatory area as part of a cellulitis.
OK let's see if I got this right.
An infection below a thrombus latches onto the thrombus and then when it lets loose it is a septic PE. Or it could be the infected stuff alone that travels.
I THINK I remember one or two cases of this, in conjunction with endocarditis (always a very serious disease requiring a long course of treatment with multiple antibiotics and ultimately open heart surgery to repair the damaged heart valves once the infection is resolved). One pt, if I remember correctly, had septic emboli which were loosed via the bloodstream from the vegetation on her heart valve--the emboli were scattered all over her body, to her brain, her liver, other places, producing grave damage. I think she originally contracted endocarditis because of rotten teeth.
When you are acutely septic you can throw micro emboli. It is nasty! They can and do go just about anywhere, lungs, brain, heart, extremities. We had a patient who was massively septic from a necrotic gallbladder. Her hands and feet turned black. Being on levophed didn't help but the actual cause was micro emoli. She lived, amazingly enough, and now has prosthetic hands and feet and is doing quite well. She wasn't a youngster when this happened either!
Sleepyeyes
1,244 Posts
I never heard of this before, and I'm not having much luck getting info. What's a septic PE? Is it dangerous? How's it treated?