Central venous septic thrombosis managed by superior vena cava Greenfield filter and venous thrombectomy: a case report

Operative management of a patient with septic thrombosis from Candida organisms of the subclavian and central veins is described. Diagnosis was suspected on the basis of positive blood and catheter tip cultures, indium-labeled leukocyte scan, and bilateral upper extremity phlebograms. Venous thrombectomy with a Fogarty catheter of the upper extremity central veins was performed after a superior vena cava Greenfield filter had been placed to prevent pulmonary embolism. The thrombus culture was positive for Candida albicans, and the reestablishment of vein patency in conjunction with amphotericin B therapy resulted in cure. This technique allows a definitive diagnosis of septic central thrombosis to be made and reestablishment of vein patency may also enhance antibiotic therapy.