Snapshot A 64-year-old man with history of severe venous insufficiency presents to his primary care physician complaing of increased swelling, temperature, and redness on the calf. Introduction Patients with superficial thrombophlebitis often present with extensive varicose veins inciting thrombus Infection in or surrounding the superficial venous network results in severe pain and redness Presentation Symptoms localized leg pain Physical exam localized erythema superficial cord-like induration palpable clot varicose veins mild fever Evaluation Diagnosis made by physical exam and history Ultrasound may be used to assess the degree of venous insufficiency look for evidence of clot Differential Deep venous thrombosis, superficial cellulitis, chronic venous insufficiency, Buerger's vasculitis, injury to the lowerl limb Treatment Medical NSAIDS for mild pain when patients refuse surgery long-term pain management and anticoagulation NOT needed in these cases Surgical thrombectomy usually performed under local anesthesis Prognosis, Prevention, and Complications Prognosis good to excellent if identified and treated early with thrombectomy pain usually subsides in a few days on its own Prevention proper management of venous insufficiency can prevent subsequent infection/inflammation Complications can potentially lead to DVT, and thus PE if not management appropriately