Recurrent deep venous thrombosis in an HIV-positive and injecting drug user woman

Vitorino Modesto Dos Santos1, Ludmila Thommen Teles, Carlos Eduardo Silva Leão

  • 1Department of Internal Medicine, Catholic University (UCB), Brasília-DF, Brazil.

Insights

This case study highlights recurrent deep venous thrombosis (DVT) in an HIV-infected intravenous drug user. It emphasizes the risks of groin injections and the link between HIV and venous thromboembolism.

Area of Science:

  • Vascular Medicine
  • Infectious Diseases
  • Cardiology

Background:

  • Deep venous thrombosis (DVT) is a significant health concern, particularly in specific patient populations.
  • Intravenous drug use (IDU) and Human Immunodeficiency Virus (HIV) infection are known risk factors for thromboembolic events.
  • Understanding the anatomical sites of drug injection is crucial for identifying potential vascular complications.

Observation:

  • A 44-year-old female with a history of IDU and HIV presented with recurrent DVT.
  • She reported injecting cocaine into the groin and dorsal foot veins, leading to multiple lower limb DVT episodes and soft-tissue infections.
  • Doppler ultrasound revealed right popliteal vein thrombosis with partial recanalization and calcified thrombi in the right femoral vein.

Findings:

  • The patient experienced recurrent episodes of deep venous thrombosis and soft-tissue infections.
  • Diagnostic imaging confirmed thrombosis in the popliteal vein and calcified thrombi in the femoral vein.
  • Treatment with heparin and oral anticoagulation resulted in an uneventful clinical course and asymptomatic discharge.

Implications:

  • This case underscores the critical need for increased awareness regarding the risks associated with injecting drugs into the groin and superficial femoral veins, which are integral to the deep venous system.
  • The association between HIV infection and an increased risk of venous thrombosis is highlighted.
  • Clinicians should consider DVT in HIV-infected individuals with a history of intravenous drug use, especially with lower limb symptoms.

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