To the Editor.—In a recent article, "Septic Nonsuppurative Thrombophlebitis" (Arch Surg 111:122, 1976), Zinner and colleagues described 11 patients with cannula-associated Gram-negative bacillary sepsis refractory to cannula removal and antimicrobial therapy. Metal ("scalp-vein") needles were implicated in seven cases. Clinical remission followed resection of mildly inflamed veins; in each case culture of the vein yielded the blood pathogen. The authors concluded that the thrombophlebitic veins constituted the source of persistent septicemia although no suppuration or organisms were identified histologically.
This report appropriately re-emphasizes iatrogenic hazards of infusion therapy. However, we have reservations about the interpretation of data presented:
Septicemia, and especially septic thrombophlebitis, arising from use of metal needles has been rare.1-33 Only one case of needle-related septicemia was detected among 535 patients in five prospective studies. Moreover, prior to this series, a total of only five cases of needle-related septicemia had been reported2; one was linked to
RHAME FS, MAKI DG. Septic Nonsuppurative Thrombophlebitis. Arch Surg. 1976;111(7):832. doi:10.1001/archsurg.1976.01360250108029