| Septic knee-induced deep venous thrombosis in a young adult. | |
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MedLine Citation:
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PMID: 20954653 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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This article describes a case of a 26-year-old man presenting with left knee pain of 1 week's duration, fever, and acute onset of shortness of breath the day of admission. An arthrocentesis of the knee joint was grossly positive for methicillin-resistant Staphylococcus aureus. A left lower extremity venous duplex showed thrombosis of the superficial femoral, popliteal, posterior tibial, peroneal, and gastrocnemius veins. Pulmonary computed tomography-angiography was positive for acute pulmonary emboli. Initial management consisted of anticoagulation, intravenous antibiotics, and 2 arthroscopic irrigation and debridement procedures. After a normal transesophageal echocardiogram, a diagnosis of septic knee-induced deep venous thrombosis (DVT) of the left lower leg with subsequent septic pulmonary emboli was established. The patient was discharged to a long-term care facility for a 6-week monitored course of intravenous antibiotics. His DVT and pulmonary emboli were managed successfully with oral warfarin. Two months after his initial presentation, the patient returned with acute worsening knee pain. A knee arthrocentesis was unremarkable; however, radiographic imaging revealed fulminant osteomyelitis of the distal femur. He has since undergone open arthrotomy with excisional irrigation and debridement and is on a chronic oral antibiotic regimen. Sparse pediatric literature has shown an association between musculoskeletal sepsis and thrombosis. Only 1 case of septic knee-induced DVT exists in the adult literature, and it was not associated with pulmonary emboli. Our case provides evidence that DVT must be considered by the treating physician as a possible and devastating complication of septic arthritis. |
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Authors:
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Jeffrey Backes; Benjamin C Taylor; Matthew D Clayton |
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Publication Detail:
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Type: Journal Article Date: 2010-10-11 |
Journal Detail:
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Title: Orthopedics Volume: 33 ISSN: 1938-2367 ISO Abbreviation: Orthopedics Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7806107 Medline TA: Orthopedics Country: United States |
Other Details:
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Languages: eng Pagination: 770 Citation Subset: IM |
Copyright Information:
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Copyright 2010, SLACK Incorporated. |
Affiliation:
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Mount Carmel Medical Center, Columbus, OH 43222, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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