[Superior vena cava and right atrium thrombosis successfully treated with streptokinase].
The case of a 56 year-old male with acute lymphoid leukemia and no signs of activity for the last four months is reported. He presented with superior vena cava thrombosis caused by a Hickman catheter, and had positive blood cultures for Candida albicans and Staphylococcus epidermidis. Despite adequate antimicrobial therapy, the fever persisted, and the patient was submitted to surgical thrombectomy. One week following the procedure, the fever returned, and thrombosis of the superior vena cava extending to the right atrium was identified by transesophageal echocardiography (TEE). The patient underwent thrombolytic therapy with streptokinase, and no thrombus could be identified in the control TEE. No hemorrhagic or thromboembolic complication occurred. The patient was discharged with oral anticoagulation.
Baruzzi
A C
AC
Hospital Israelita Albert Einstein, São Paulo.
Katz
A
A
Smith
M R
MR
Aun
R
R
Cirenza
C
C
Araujo
A L
AL
Knobel
E
E
D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology; D017548:Echocardiography, Transesophageal; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013300:Streptokinase / Q000627:therapeutic use*; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D017131:Thrombectomy
D005343:Fibrinolytic Agents; D013300:Streptokinase