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The SARS-CoV-2 responsible for phlegmasia cerulea dolens: a case report

Youssef Banana1, Husam Bashir1, Sara Boukabous2

  • 1Departments of Vascular Surgery.

Annals of Medicine and Surgery (2012)
|April 3, 2023
PubMed

Insights

This case study highlights a rare instance of phlegmasia cerulea dolens (PCD) in a COVID-19 patient. Early recognition and intervention are crucial for managing this severe thrombotic complication of coronavirus disease 2019.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus disease 2019 (COVID-19) is a systemic infection linked to coagulopathies.
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can trigger thrombotic events via inflammation and cytokine storms.

Observation:

  • A COVID-19 patient presented with phlegmasia cerulea dolens (PCD) affecting the left lower limb.
  • PCD is characterized by venous stasis, diminished pulses, and critical limb ischemia.
  • This presentation is rare among reported COVID-19 thrombotic complications, which more commonly include deep vein thrombosis, pulmonary embolism, and stroke.

Findings:

  • The patient underwent aponeurotomies of the internal and anterolateral muscular compartments for PCD treatment.
  • SARS-CoV-2 is recognized as a thrombogenic pathogen, increasing the risk of various thromboembolic events.

Implications:

  • The case underscores the importance of monitoring for vascular thrombosis markers in COVID-19 patients.
  • While anticoagulation is hypothesized for SARS-CoV-2, its systematic use requires further investigation.
  • Prompt recognition and management of rare complications like PCD are vital in COVID-19 care.

Keywords:
coronavirus disease 2019phlegmatia cerulea dolensthrombosis

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