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September 29, 1978

Upper-Extremity Suppurative Thrombophlebitis and Septic Pulmonary Emboli

Author Affiliations

From the Department of Surgery, Albert Einstein College of Medicine, Bronx, NY.

JAMA. 1978;240(14):1519. doi:10.1001/jama.1978.03290140061029

THROMBOSIS of the deep veins of the upper extremity accounts for less than 2% of all deep-vein thromboses. The disease is a potentially serious condition and, in addition to causing the local complication, may be responsible for systemic manifestations. Adams and co-workers1 reported 12% incidence of pulmonary emboli in a series of 25 patients with upper-extremity deep-vein thrombosis, and a similar incidence of pulmonary emboli originating from the veins of the upper extremities has been quoted by other authors.2 An additional, possibly fatal complication of the upper-extremity deep thrombophlebitis occurred in the form of a septic embolization.

Report of a Case  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