Acute Aortic Thrombosis with Limb Ischemia in a Patient with Influenza A

Influenza A is associated with venous and, less commonly, arterial thrombosis. Stroke and myocardial infarction comprise most arterial events, with only rare involvement of the aorta and peripheral arteries.

We report a 61-year-old male hospitalized for influenza A pneumonia and rhabdomyolysis who developed acute right lower limb ischemia on day 7 of his admission. Computed tomography scan of the abdomen revealed acute descending and infrarenal aortic thrombosis with embolic occlusion of the right popliteal artery. He underwent successful embolectomy and fasciotomy with good functional outcome.

This case demonstrates that Influenza A infection may provoke severe and unusual thrombotic events, even during the convalescent phase of illness. Prompt diagnosis and intervention are required to reduce the risk of limb amputation and mortality.

While influenza A is a known trigger for major arterial events such as stroke and myocardial infarction, this report demonstrates it may also provoke peripheral arterial thrombosis, resulting in critical limb ischemia.The diagnosis of arterial thrombosis requires a high index of suspicion, as it may occur during the convalescent phase of illness and result in loss of limb and death without emergent intervention.Although case reports suggest arterial thrombosis may be mediated by disease severity and traditional cardiovascular risk factors, limb ischemia may develop in patients without a prior history of thrombosis or established cardiovascular disease.