Upper-extremity suppurative thrombophlebitis and septic pulmonary emboli

G. Weinberg, B. M. Pasternak

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

A 33-year-old male heroin addict was admitted to a hospital complaining of pain in the right arm, malaise, dyspnea, and cough. Several weeks before admission, he attempted to inject heroin into his right antecubital vein. At the time of admission, his temperature was 38.9°C, and he had tachypnea of 30/min. The right arm was swollen and tender above the elbow, with maximal tenderness over the medial aspect of the arm and axilla. There were prominent, distended, superficial veins present over the right arm, shoulder, and anterior chest wall. The rest of the physical examination showed no abnormalities. The patient continued to run a septic course, and repeated lung scan demonstrated extension of the embolic process; therefore, surgical division of the subclavian vein was recommended. Through the upper median sternotomy incision, the right innominate vein was exposed, and the right subclavian vein was divided between ligatures just distal to the junction with the internal jugular vein. Culture of the resected segment of the vein grew β-hemolytic Streptococcus. The patient's condition improved dramatically within 48 hours following surgery. He became afebrile, and the dyspnea and cough disappeared. After an additional three-week course of antibiotic therapy, he was discharged with only a minor degree of edema of the right upper extremity and in a good general condition.

Original languageEnglish (US)
Pages (from-to)1519
Number of pages1
JournalJournal of the American Medical Association
Volume240
Issue number14
DOIs
StatePublished - 1978

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Thrombophlebitis
Embolism
Upper Extremity
Arm
Subclavian Vein
Veins
Lung
Heroin
Cough
Dyspnea
Brachiocephalic Veins
Tachypnea
Axilla
Sternotomy
Jugular Veins
Thoracic Wall
Elbow
Streptococcus
Physical Examination
Ligation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Upper-extremity suppurative thrombophlebitis and septic pulmonary emboli. / Weinberg, G.; Pasternak, B. M.

In: Journal of the American Medical Association, Vol. 240, No. 14, 1978, p. 1519.

Research output: Contribution to journalArticle

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