title: [Deep venous thrombosis complications during infections in pediatric patients: analysis of a series of 24 cases].
abstract: Venous thromboembolism disease (VTE) is rare in children (5.3 of 10,000 hospitalized children). However, morbidity and mortality are high, especially when the child is already suffering from severe sepsis. We report an analytical study of 24 cases of deep venous thrombosis occurring in children during infection, recorded at the Montpellier University Hospital between 1999 and 2009. Many parameters were studied in each population (age, sex, familial and personal history of thrombosis, history of thrombophilia, the presence of a venous catheter, a causative organism, time to onset of thrombus, topography of lesions, acquired abnormalities of hemostasis, and thrombosis prophylaxis). The children were aged from 1 day of life to 16 years. Thromboses occurred in two clinical contexts: "contact" thrombosis (which appeared near the infection) and disseminated thrombosis. This is an early complication because in most of the cases, it appeared in the first 10 days of sepsis. Infection and coagulation appear to be closely related and the states of latent or decompensated disseminated intravascular coagulation are common. Nevertheless, it is not possible to predict the occurence of a thrombotic event. The presence of risk factors (venous catheters, acquired thrombophilia, or constitutional thrombophilia) may increase the thrombogenic potential of the infection. VTE should always be suspected and sought in case of an unfavorable clinical course, and routine prophylaxis of thrombosis during sepsis should be discussed.
authors.affiliation: Service de médecine interne B et maladie vasculaire, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France. Electronic address: m-nou@chu-montpellier.fr.
authors.forename: M
authors.initials: M
authors.lastname: Nou
authors.affiliation: Service de pédiatrie III, hôpital Arnaud de Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Rodière
authors.affiliation: Service d'hématologie, hôpital Saint-Éloi, 34295 Montpellier, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Schved
authors.affiliation: Service de médecine interne B et maladie vasculaire, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Laroche
authors.affiliation: Service de médecine interne B et maladie vasculaire, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
authors.forename: I
authors.initials: I
authors.lastname: Quéré
authors.affiliation: Service d'explorations vasculaires, centre hospitalier universitaire Carémeau (NIMES), rue du Professeur-Debré, 30029 Nîmes cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Dauzat
authors.affiliation: Service de pédiatrie III, hôpital Arnaud de Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France. Electronic address: eric.jeziorski@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Jeziorski
mesh_terms: D000293:Adolescent; D001778:Blood Coagulation Disorders / Q000175:diagnosis; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000150:complications* / Q000382:microbiology / Q000821:virology; D008297:Male; D012307:Risk Factors; D020246:Venous Thrombosis / Q000150:complications*