From the Guidelines
Phlebitis is inflammation of a vein, typically occurring in the legs, which can be caused by a blood clot (thrombophlebitis) or irritation of the vein wall without clotting (superficial phlebitis) 1. This condition can manifest as redness, warmth, tenderness, and swelling along the affected vein.
Causes and Risk Factors
The causes of phlebitis include damage to the vein wall from trauma, intravenous catheters, or underlying conditions that increase clotting risk, such as prolonged immobility, pregnancy, or certain medications 1.
Diagnosis and Treatment
Diagnosis often involves ultrasound imaging to confirm the presence of a clot and to rule out other conditions 1. Treatment for superficial phlebitis typically involves anti-inflammatory medications and warm compresses, while deep vein thrombophlebitis may require anticoagulation therapy 1.
Management
For superficial phlebitis exceeding 5 cm in length, prophylactic dose fondaparinux or low molecular weight heparin (LMWH) is recommended for 45 days 1. It is essential to seek medical attention if symptoms worsen or if fever develops, as this could indicate a more serious infection or complication 1. Some key points to consider in the management of phlebitis include:
- The use of anticoagulant therapy alone over interventional therapy for acute DVT of the leg 1
- The recommendation for anticoagulation therapy for at least the treatment phase (first 3 months) in patients with cerebral vein/venous sinus thrombosis 1
- The suggestion for clinical surveillance over anticoagulation in patients with subsegmental pulmonary embolism and no proximal DVT in the legs who have a low risk for recurrent VTE 1
From the Research
Definition of Phlebitis
Phlebitis refers to inflammation of a vein, which can be caused by a blood clot, infection, or injury to the vein. It can occur in both superficial and deep veins.
Types of Phlebitis
- Superficial phlebitis: occurs in superficial veins and is characterized by inflammation and clotting of the vein, often caused by trauma, infection, or other factors 2, 3.
- Deep vein phlebitis: occurs in deep veins and can be more serious, potentially leading to complications such as pulmonary embolism 4, 5.
Characteristics of Phlebitis
- Inflammation of the vein wall
- Clotting of the vein
- Pain, swelling, and redness in the affected area
- Warmth and tenderness to the touch
Differential Diagnosis
Phlebitis can be differentiated from other conditions such as phlebosclerosis and phlebothrombosis through histopathologic examination 3, 6. Accurate diagnosis is essential to determine the underlying cause and guide treatment.
Treatment and Prevention
Treatment of phlebitis typically involves anti-inflammatory agents, analgesics, and compression therapy 2. In some cases, anticoagulants may be necessary to prevent further clotting. Prevention of phlebitis includes avoiding trauma to the veins, staying mobile, and managing underlying medical conditions that may increase the risk of phlebitis 2, 5.