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August 1986

Septic Thromboarteritis

Arch Surg. 1986;121(8):974-975. doi:10.1001/archsurg.1986.01400080122026

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To the Editor.—Septicemia secondary to radial artery catheterization is recognized but uncommon. Recommendations for treatment include removal of the catheter and administration of parenteral antibiotics.1 One patient with staphylococcal septicemia from this source did not respond to this conventional therapy and additionally required excision of the infected artery to effect resolution.

Report of a Case.—A 58-year-old man was admitted for elective excision of the left upper pulmonary lobe for bronchogenic squamous carcinoma. Preoperative pulmonary function was severely impaired and necessary perioperative arterial monitoring was achieved with a percutaneous Teflon catheter. Prolonged postoperative ventilatory support was required, necessitating continuous monitoring for eight days, by which time the catheter site showed local signs of infection. The catheter was removed, but the patient became febrile and developed leukocytosis 24 hours later. Systemic sepsis persisted despite intensive, appropriate (nafcillin, 6 g/d), intravenous antibiotic therapy (Figure). After positive blood cultures, tenderness, swelling,

Baker RJ:  Monitoring in critically ill patients . Surg Clin North Am 1977;57:1139-1158.
Stein JM, Bruitt BA:  Suppurative thrombophlebitis . N Engl J Med 1970;282:1452-1455.Article