title: Bacteremia and Deep Vein Thrombosis in an Infant.
abstract: BACKGROUND
  Deep vein thrombosis (DVT) is rare in infancy. In pediatric populations, thrombosis occurs most frequently in hospitalized children and those with central venous catheters. The presence of a DVT in the general pediatric population indicates a hypercoagulable state and requires rapid diagnosis and treatment of both the thrombosis and the underlying process.
  
  
  METHODS
  A previously healthy 6-month-old male was brought to the emergency department by his family with a chief complaint of left leg swelling. Duplex ultrasonography in the emergency department revealed multiple DVTs in the leg vasculature. The patient was treated with anticoagulation and antibiotic therapy in the emergency department and admitted. Blood cultures revealed the subsequent growth of methicillin-resistant Staphylococcus aureus (MRSA). WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: While rare in infants, new-onset swelling in an extremity may be caused by thrombosis and be the initial symptom of an underlying hypercoagulable state. Duplex ultrasonography is a relatively benign test that can be readily performed in most emergency departments, and it allows physicians to rule out thrombosis. When present, DVT in the general pediatric population can indicate a critical illness, such as malignancy or infection, and requires rapid treatment and admission to a pediatric service for management.
authors.affiliation: Department of Emergency Medicine, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana; Our Lady of the Lake Children's Hospital, Baton Rouge, Louisiana.
authors.forename: Louis G
authors.initials: LG
authors.lastname: Pruitt
authors.affiliation: Department of Emergency Medicine, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana; Our Lady of the Lake Children's Hospital, Baton Rouge, Louisiana.
authors.forename: Joel C
authors.initials: JC
authors.lastname: Mosley
authors.affiliation: Department of Emergency Medicine, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana; Our Lady of the Lake Children's Hospital, Baton Rouge, Louisiana.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Lasseigne
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000503:physiopathology; D002443:Ceftriaxone / Q000494:pharmacology / Q000627:therapeutic use; D002981:Clindamycin / Q000494:pharmacology / Q000627:therapeutic use; D004487:Edema / Q000150:complications / Q000209:etiology / Q000503:physiopathology*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D017984:Enoxaparin / Q000494:pharmacology / Q000627:therapeutic use; D005334:Fever / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity*; D014463:Ultrasonography / Q000379:methods; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D017984:Enoxaparin; D002981:Clindamycin; D014640:Vancomycin; D002443:Ceftriaxone
keywords: DVT; MRSA; bacteremia; pediatrics