Acinetobacter pittii thrombophlebitis complicating cyanoacrylate closure procedure

Abstract

Chronic venous disease is a common condition causing pain, discomfort, and skin changes that effect quality of life and productivity. Various treatment modalities have been developed to manage retrograde venous blood flow and its associated complications, ranging from conservative therapy to more invasive techniques such as endothermal ablation and cyanoacrylate closure (CAC). Recently, CAC has gained popularity due to its faster recovery time and lower incidence of postprocedure discomfort and complications. The most commonly reported side effects include phlebitis, access site bruising or pain, and dermatitis. We present a case of phlebitis caused by Acinetobacter pittii following a CAC procedure using the VenaSeal device (Medtronic) in a patient with diabetes. The patient required surgical resection of the affected vein and prolonged antibiotic therapy. Bacterial contamination of the cyanoacrylate adhesive within a vein poses a significant treatment challenge with antibiotics alone due to biofilm production. Aggressive source control with removal of the adhesive-treated vein could be required for treatment of endovascular infections resulting from these common procedures.

Keywords

• Acinetobacter pittii
• Chronic venous disease
• Cyanoacrylate closure procedure