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Deep vein thrombosis associated with pediatric musculoskeletal sepsis
Stewart Walsh1, Fredrick Phillips
1Department of Pediatric Orthopaedic Surgery, Starship Children's Hospital, Auckland, New Zealand.
Insights
Deep vein thrombosis (DVT) in children is rare but can occur with musculoskeletal sepsis. This condition can lead to severe complications, including death, highlighting the need for prompt diagnosis and treatment.
Area of Science:
- Pediatric Hematology
- Pediatric Infectious Diseases
- Pediatric Critical Care Medicine
Background:
- Deep vein thrombosis (DVT) is infrequently diagnosed in pediatric populations.
- Musculoskeletal sepsis presents a unique risk factor for DVT development in children.
Observation:
- The study details four pediatric cases where DVT occurred concurrently with musculoskeletal sepsis.
- One pediatric patient with DVT and musculoskeletal sepsis experienced a fatal outcome.
Findings:
- Prothrombotic screening in surviving patients revealed normal hematologic parameters, suggesting non-thrombophilic factors.
- The severity of DVT associated with musculoskeletal sepsis is significant, with a notable risk of septic emboli.
Implications:
- Pediatric deep vein thrombosis should be considered in cases of musculoskeletal sepsis, especially with severe limb swelling.
- Early recognition of DVT in pediatric musculoskeletal sepsis is crucial to prevent potentially fatal septic embolic events.
Abstract:
Deep vein thrombosis (DVT) is uncommon in children but can occur given certain circumstances. The authors describe four children in whom DVT developed in association with musculoskeletal sepsis. One child died. Prothrombotic screens were performed on the three surviving children, showing normal hematologic parameters. The severity of DVT complicating musculoskeletal sepsis is emphasized, particularly the potential for septic embolic complications. Deep vein thrombosis should be considered in any child with musculoskeletal sepsis, particularly when a limb is severely swollen or when there are pulmonary septic emboli.