DVT and pulmonary thromboembolism in a paediatric patient: A
The following case has been published in the Journal of Postgraduate Medicine.

Deep vein thrombosis and pulmonary thromboembolism are rare and life threatening emergencies in children. The authors report an 11-year old child who presented with acute complaints of high grade fever, pain in the left thigh and inability to walk and breathlessness since 6 days.

On physical examination, there was a diffuse tender swelling of the left thigh, tachypnea, tachycardia with hyperdynamic precordium and bilateral basal crepitations. Ultrasonography and venous doppler of lower limbs showed mild effusion of left hip joint and thrombus in the left common femoral vein and left external iliac vein suggesting a diagnosis of septic arthritis with thrombophlebitis.

The tachypnea and tachycardia which was out of proportion to fever and crepitations on auscultation prompted suspicion of an embolic phenomenon. Radiograph of the chest revealed multiple wedge shaped opacities in the right middle zone and lower zone suggestive of pulmonary embolism and left lower zone consolidation.

For corroboration, CT pulmonary angiography and CT of abdomen was performed which revealed pulmonary thromboembolism and deep venous thrombosis extending up to infrarenal inferior vena cava.

On further workup, MRI of hips showed left femoral osteomyelitis and multiple intramuscular abscesses in the muscles around the hip joint.

Blood culture grew methicillin resistant Staphylococcus aureus. Antibiotics were changed according to culture sensitivity and there was a dramatic response. After four weeks of anticoagulation and antibiotics the child became asymptomatic and thrombus resolved.

Major Takeaway:-
- Thus, it is crucial to consider methicillin resistant Staphylococcus aureus infection as an important infection when we encounter such a clinical scenario.

- This case report highlights an unusual and potentially life threatening presentation of a virulent strain of a common pathogen, which when diagnosed was completely amenable to treatment.

Read about the case in detail here: https://pxmd.co/qDCYp
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