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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe two patients with deep venous thrombosis of the upper extremity who initially were thought to have septic arthritis of the shoulder. These patients had a history of recent intravenous cocaine abuse. The diagnosis of deep venous thrombosis should be considered when a patient with a swollen shoulder has an appropriate history.
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PMID:Deep venous thrombosis in intravenous cocaine abuse mimicking septic arthritis of the shoulder. 199 Apr 71

Two cases are reported of toxic shock syndrome in patients with pyogenic arthritis due to Staph. aureus with proven production of enterotoxin F and pyogenic exotoxin C. An ischemic complication of both lower extremities in one of the patients may be related to the use of a heparin-dihydroergotamine combination for postoperative prophylaxis of deep vein thrombosis.
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PMID:[Toxic shock syndrome in pyogenic arthritis]. 716 2

Septic arthritis and osteomyelitis in children is seldom accompanied by calf vein thrombosis and rarely by atrial thrombosis. We report the case of an 11-year, 5-month-old boy with septic arthritis and osteomyelitis of the sacroiliac region who developed deep venous thrombosis, in addition to life-threatening right atrial thrombosis. After an intensive hematologic investigation, a hereditary protein C deficiency was revealed. The association of venous thrombosis with septic arthritis or osteomyelitis should raise the possibility of the presence of protein C deficiency.
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PMID:Atrial and venous thrombosis secondary to septic arthritis of the sacroiliac joint in a child with hereditary protein C deficiency. 1008 80

The authors' experience using anterior T-frame external fixation combined with percutaneous internal fixation for treatment of high-energy proximal tibial fractures is reported. Thirty-six patients (38 fractures) were reviewed who were treated during a consecutive 42-month period. Three patients died and one patient had an amputation for a Type IIIC open injury, leaving 20 males and 12 females with 21 closed and 13 open fractures (two Type II, seven Type IIIA, three Type IIIB, and one Type IIIC). The average followup was 26 months. Fractures united at a mean of 20 weeks. Ten secondary surgical procedures were planned, including seven antibiotic bead removals with autogenous bone grafting and three soft tissue coverage procedures. Nine (26%) complications were found, including one deep infection (septic arthritis) and three pin tract infections, and one each malunion, nonunion, refracture, knee stiffness requiring manipulation under anesthesia, and deep venous thrombosis. The average Knee Society score was 85 for pain and 83 for function. All patients achieved full knee extension and mean flexion was 125 degrees. The anterior T-frame external fixator with percutaneous internal fixation is a reliable method to stabilize these injuries. It is simple, inexpensive, and effective.
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PMID:The anterior T-frame external fixator for high-energy proximal tibial fractures. 1106 97

DVT is a potentially serious disease and can serve as a marker for PE, an entity with even higher morbidity. Thus, it is critically important that emergency physicians consider this diagnosis in patients who present with suspicious symptoms. Recognition of alternative conditions, such as compartment syndrome, septic arthritis, and cellulitis, is also important for optimal care. Because physical examination is only 30% accurate for DVT, it serves to increase clinical suspicion in patients at risk but cannot be used to eliminate the possibility of thromboembolic disease. Because of this limitation, the diagnosis of DVT should be pursued using adjunctive testing in any patient with unexplained limb pain or swelling. Duplex sonography is currently the initial diagnostic study of choice for evaluation of DVT and, if test results are negative, it should be repeated serially if the clinical suspicion is high.
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PMID:Physical examination findings in deep venous thrombosis. 1176 76

Childhood septic arthritis is not only an uncommon presentation with polyarticular involvement, but is also rarely complicated with thromboembolism. We report a case of a 10-year-old boy who suffered multiple staphylococcal arthritis, deep vein thrombosis, pulmonary embolism, pericardial effusion and occlusion of the anterior parietal branch of the right middle cerebral artery. Oxacillin-sensitive Staphylococcus aureus was isolated from blood, synovial fluid and pericardial effusion. Intravenous six-week oxacillin combined with two-week gentamicin for eradicating the pathogen, arthrotomy for debridment and subcutaneous low-molecular-weight heparin for preventing further thromboembolism were administered during admission. In addition, surveys for immunodeficiency, connective tissue disease and hemostatic dysfunction produced negative findings. The patient was discharged with neither painful disability of involved joints nor neurological sequelae.
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PMID:Disseminated staphylococcal disease: report of one case. 1630 85

A 14-year-old immunocompetent adolescent presented systemically unwell with left knee septic arthritis. Within several days, disseminated bone and soft tissue collections became evident, associated with deep venous thrombosis and pulmonary involvement. Methicillin-sensitive Staphylococcus aureus was isolated, harbouring Panton-Valentine leucocidin genes. Aggressive antibiotic and surgical therapies eventually lead to recovery. Intrafamilial spread of the pathogenic isolate was shown by household screening. This presentation is consistent with 'PVL Syndrome' and is typical of severe S. aureus infection emerging in young populations globally.
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PMID:Fulminant methicillin-sensitive Staphylococcus aureus infection in a healthy adolescent, highlighting 'Panton-Valentine leucocidin syndrome'. 1704 Mar 63

We present the case of a 53-y-old patient who complained of fever, pain and oedema of the right knee and the right calf. Colour ultrasonography showed thrombosis of the tibial and peroneal veins, while paracentesis of the knee joint showed characteristics of an inflammatory exudate. Culture of the arthritic fluid revealed Streptococcus pyogenes. Thus, a diagnosis of a septic arthritis of the right knee in association with deep venous thrombosis of the right lower leg was established. From a review of the literature we found no other cases of septic arthritis in association with thrombosis of the adjacent vein. In conclusion, in cases of septic arthritis of a joint one has to consider ruling out thrombosis of the adjacent venous vessels, especially when oedema is not confined to the joint. Missing the diagnosis of such a complication will lead to increased morbidity and mortality.
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PMID:Knee septic arthritis due to Streptococcus pyogenes associated with acute thrombosis of the tibial and peroneal veins: case report and review of the literature. 1745 6

A 39-year-old man with a history of deep vein thrombosis and septic arthritis of the left knee was treated with warfarin and cefazolin. Therapeutic prothrombin times and international normalized ratios (INRs) were maintained with warfarin 32 mg/week for approximately 1 month. When the patient's antibiotic regimen was changed from cefazolin to nafcillin 2 g every 4 hours, his INR declined significantly. His warfarin dosage had to be increased to a maximum of 88 mg/week to achieve a therapeutic INR. After completion of antibiotic therapy with nafcillin, the patient's warfarin requirements slowly declined over several weeks. A maintenance dosage of warfarin 42-48 mg/week was necessary after nafcillin discontinuation. Hepatic cytochrome P450 isoenzyme induction by nafcillin is likely the mechanism of a warfarin-nafcillin interaction. The usual onset of effect is within 1 week after starting nafcillin, and the offset of the effect is usually evident within 4 weeks after nafcillin discontinuation. In patients taking warfarin who are prescribed nafcillin, a 2-4-fold increase in the warfarin dose may be necessary, and clinicians should closely monitor INRs.
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PMID:Interaction between warfarin and nafcillin: case report and review of the literature. 1789 3

A 14-year-old patient presented with bilateral pneumonia and pleural effusions, septic arthritis of the hip, deep venous thrombosis, and pulmonary thromboembolism. Methicillin-sensitive Staphylococcus aureus (S. aureus) containing the Panton Valentine Leukocidin (PVL) genes was isolated. Contraindication to anticoagulation prompted inferior vena cava filter placement. He completed 4 weeks of treatment with flucloxacillin, with good clinical outcome. S. aureus containing PVL genes should be sought in cases of necrotizing pneumonia as it seems to increase the risk of severe multifocal infection and thrombotic complications. There are few reports of placement of filters during S. aureus sepsis and bacteraemia. This case highlights that when anticoagulation is not feasible, an inferior vena cava filter can be inserted safely, even in patients with active sepsis and high risk for seeding of the filter. Long-term follow-up confirmed a successful outcome with sterilization of the septic thrombosis with no further pulmonary embolism or additional sepsis episodes.
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PMID:Septic Pulmonary Embolism Case Report: Optimal Outcome after Insertion of an Inferior Vena Cava Filter in a Patient with Staphylococcus aureus Bacteraemia. 2062 14


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