All Journals from J Bhullar
The treatment of infective endocarditis remains controversial with differing advice regarding timing of surgery in current guidelines.
DH Kang, YJ Kim, SH Kim et al. N Engl J Med 2012; 366: 2455-2473.
The treatment of infective endocarditis remains controversial with differing advice regarding timing of surgery in current guidelines.
Case History
A 55 year old male presented to the Acute Medical Unit with a one hour history of pain and swelling of his right leg with resultant inability to weight bear. He denied any preceding history of trauma. Previous medical history was unremarkable. He was taking no regular medications, and did not use recreational drugs. There was no prior weight change, or alteration in bowel habit, no associated chest pain or dyspnoea and there were no risk factors for venous thromboembolism or arterial thrombotic disease. He was a lifelong non-smoker.
Case Outcome
Urgent Duplex ultrasound demonstrated ilio-femoral deep vein thrombosis (DVT) with involvement of the long saphenous and short saphenous superficial veins. Arterial Doppler waveforms were normal distally with no evidence of stenosis. The diagnosis was therefore Phlegmasia cerulea dolens (PCD), resulting from an extensive, proximal DVT with total or near total venous outflow occlusion.