An Unusual Case of Deep Vein Thrombosis and Concurrent Necrotizing Fasciitis Following a Fall.
| Autor: | Rohail MU; Medical School, West Virginia School of Osteopathic Medicine, Lewisburg, USA., Khan A; Medical School, West Virginia School of Osteopathic Medicine, Lewisburg, USA., Maloof J; Radiology, Kanawha Valley Radiologists, Charleston, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 Jan 18; Vol. 15 (1), pp. e33934. Date of Electronic Publication: 2023 Jan 18 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.33934 |
| Abstrakt: | A 74-year-old male patient presented to the emergency department following a fall with signs and symptoms consistent with right lower extremity (RLE) deep vein thrombosis (DVT) and non-specific skin changes. Further imaging confirmed the initial diagnosis of DVT, and the patient was appropriately treated. However, his condition continued to deteriorate with worsening overlying skin changes, which prompted a computed tomography (CT) scan of his right femur without intravenous (IV) contrast. This revealed fluid tracking along the lateral compartment muscles, which raised suspicion of an abscess. Suspicion for necrotizing fasciitis (NF) was raised with a subsequent CT of the right femur with IV contrast that demonstrated a considerable increase in rim-enhancing fluid collections intramuscularly and extending into both the anterior and posterior compartments, likely correlating with increasing intermuscular abscesses. On imaging, no subcutaneous emphysema or gas accumulation was found, which is a common finding in NF. However, necrotic-appearing muscle was found on surgical debridement and wound cultures confirmed the diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) NF. The patient was then treated with appropriate IV antibiotics and was discharged to long-term inpatient wound care. Similar presentations of DVT and NF made a prompt diagnosis of NF difficult, and it highlights the need for further imaging to rule out NF when a patient has a confirmed diagnosis of DVT. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Rohail et al.) |
| Databáze: | MEDLINE |
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