Septic Thrombophlebitis Complicating a Peripherally Inserted Central Catheter

Peripherally inserted central venous catheters are associated with several complications. Thrombosis, catheter-related infection and phlebitis are well-recognized complications. However, septic thrombophlebitis is very rare. We describe a 44-year-old patient with heart failure who developed extensive septic thrombophlebitis of the right internal jugular, brachicephalic, facial veins and superior vena cava as a complication of prolonged use of a peripherally inserted central venous catheter that was inserted for dobutamine infusion. The catheter was displaced into the internal jugular vein by manipulation of the patient who used it for injection of illegal drugs. Blood cultures grew Citrobacter amalonaticus and Coagulase-negative Staphylococcus with the former growing more often making it the more likely causative agent. The patient was treated successfully with antibiotics and anticoagulation. To our knowledge Citrobacter amalonaticus has not been previously recognized to be associated with septic thrombophlebitis. J Med Cases. 2012;3(3):174-177 doi: https://doi.org/10.4021/jmc560w