Abstract
A 35-year-old woman with schizophrenia was brought to our hospital because of multiple fractures as a result of a fall. Catheterization was performed via her right internal jugular vein as treatment in the intensive care unit. After 12 days of hospitalization, she had a fever of 39°C; as a result, catheter infection was suspected, and the catheter was removed. Blood culture revealed Enterococcus faecium. Antibiotic therapy was administered during the subsequent 19 days of hospitalization. However, pus discharge was observed from her right cervix. Computed tomography showed thrombophlebitis extending from the brachiocephalic vein to the right internal jugular vein. A risk of pulmonary embolism and the need for infection control necessitated surgery. We adopted a 2-operation approach—a right cervical incision and median sternotomy—and performed thrombectomy of the brachiocephalic vein and excision of the internal jugular vein. Operative therapy was effective for the management of infective thrombosis refractory to antibiotic therapy.
