A Rare Case of Septic Deep Vein Thrombosis in the Inferior Vena Cava and the Left Iliac Vein in an Intravenous Drug Abuser

Koh, Ye‐Xin; Ch’ng, Jack Kian; Tan, Seck Guan

doi:10.3400/avd.cr.12.00036

Cited by 9 publications

(5 citation statements)

References 20 publications

(19 reference statements)

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“…Other common complications are postthrombotic syndrome, which can occur in up to 50% of patients with DVT and chronic thromboembolic pulmonary hypertension that might be present in 3.3% of patients with other risk factors besides being an intravenous drug abuser and that usually presents after 10 years of having the first episode of DVT. These clinical manifestations affect the patients by lowering quality-of-life scores when compared to the general population and by increasing their rates of mortality [6,[33][34][35][36].…”

Section: Review Epidemiologymentioning

confidence: 99%

“…It is more prevalent in frequent long-term IVDU, which can be confirmed by helical CT or color-coded Doppler ultrasound [ 115 ]. Manifestations include fever, chills, rigors, and draining sinus with further life-threatening complications such as septic PE and right-sided infective endocarditis [ 35 ]. The mainstay of treatment is intravenous b-lactamase-resistant penicillin [ 115 ].…”

Section: Reviewmentioning

confidence: 99%

“…The mainstay of treatment is intravenous b-lactamase-resistant penicillin [ 115 ]. Other treatments aimed at preventing further embolization and removing thrombus include catheter-directed thrombolysis, mechanical thrombectomy, surgical thrombectomy, and phlebectomy [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

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Deep Vein Thrombosis in Intravenous Drug Users: An Invisible Global Health Burden

Jain¹,

Avanthika²,

Singh³

et al. 2021

Cureus

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The prevalence of intravenous drug use has increased in the past decade and it represents an important risk factor for deep vein thrombosis. Intravenous drug use is a global problem, with the main culprit being heroin. Peer pressure and poverty in high-risk groups such as sex workers, females, and young adults raise the risk of intravenous drug use, which expresses itself in the form of venous thromboembolism eventually. Deep vein thrombosis typically manifests itself eight years after the initial intravenous drug administration, rendering it a silent killer.Aiming to review and summarize existing articles in this context, we performed an exhaustive literature search online on PubMed and Google Scholar indexes using the keywords "Deep Venous Thrombosis (DVT)" and "Intravenous Drug Users (IVDU)." English articles that addressed epidemiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, management, and outcomes of DVT, including those in IVDU, were selected and analyzed.The pathogenesis of DVT development in IVDU is mainly attributed to the interplay of trauma to the vessel by repeated injection and the injected drug itself. The right-sided femoral vein is the most common vein affected. Prevalent clinical presentations include local pain, swelling, and redness with typical systemic symptoms including fever, cough, dyspnea, and chest pain on top of addiction features. There appeared to be a delay in reporting symptoms, which was most likely due to the social stigma attached to IVDU.There are over 50 conditions that present with swollen and painful limbs comparable to DVT in IVDU, making precise diagnosis critical for timely treatment. Venous ultrasound is the method of choice for diagnosing DVT. Extended anticoagulant therapy with low-molecular-weight heparin combined with warfarin is the recommended treatment. Intravenous drug abusers having DVT are affected by multiple complications and poorer outcomes such as slower recovery, recurrent venous thromboembolism (VTE), and a longer hospital stay, which put them at higher risk of morbidity, mortality, reduced productivity, and economic burden.

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Section: Review Epidemiologymentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Deep Vein Thrombosis in Intravenous Drug Users: An Invisible Global Health Burden

Jain¹,

Avanthika²,

Singh³

et al. 2021

Cureus

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“…123 A rare case of DVT in the inferior vena cava and left iliac vein in an intravenous drug user has also been described. 124 Drug injections alone are not a risk factor for deep vein thrombosis; however, intravenous injection of these substances is an independent risk factor. 125 For example, heroin triggers an increase in α-2 adrenergic receptor density platelets that can stimulate platelet aggregation dependent on adrenaline.…”

Section: Clinical Aspectsmentioning

confidence: 99%

<p>Microbial Modulation of Coagulation Disorders in Venous Thromboembolism</p>

Lichota

Gwoździński

Szewczyk

2020

JIR

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Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third leading cause of cardiovascular death in the world. Important risk factors of thrombosis include bed restraint, surgery, major trauma, long journeys, inflammation, pregnancy, and oral contraceptives, previous venous thromboembolism, cancer, and bacterial infections. Sepsis increases the risk of blood clot formation 2-20 times. In this review, we discussed various mechanisms related to the role of bacteria in venous thrombosis also taking into consideration the role of the human microbiome. Many known bacteria, such as Helicobacter pylori, Chlamydia pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, and Escherichia coli, causing infections may increase the risk of thrombotic complications through platelet activation or may lead to an inflammatory reaction involving the fibrinolytic system. Additionally, the bacteria participate in the production of factors causing or increasing the risk of cardiovascular diseases. An example can be trimethylamine N-oxide (TMAO) but also uremic toxins (indoxyl sulfate), short-chain fatty acids (SCFA) phytoestrogens, and bile acids. Finally, we presented the involvement of many bacteria in the development of venous thromboembolism and other cardiovascular diseases.

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“…In IVDAs with IE, TV is commonly involved in about 60%-80% of cases, with reported mortality of 5%-10% [9] . In a study of 105 IVDAs with IE, 86% were right sided and 14% [27] . Right heart failure is common due to acute pulmonary hypertension or severe TR or TV obstruction [9,11] .…”

Section: Diagnosismentioning

confidence: 99%

Intravenous drug abuse and tricuspid valve endocarditis: Growing trends in the Middle East Gulf region

Panduranga

Al-Abri

Al-Lawati

2013

WJC

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Traditionally, tricuspid valve endocarditis is uncommon in the Middle East region. However, recent global data indicate growing trends in the use of illicit drug abuse, specifically injectable heroin, in the Middle East Gulf region. The presence of many transit port services in the Middle East Gulf States has led to smuggling of substance abuse drugs in the region. The Middle East Gulf States, currently a transit market, are also becoming a growing consumer market in view of the increased substance abuse in the youth. However, there is a paucity of data with respect to the prevalence or incidence of tricuspid valve endocarditis in the region, probably due to underdiagnosis or underreporting. A high index of suspicion of tricuspid valve endocarditis is essential in patients with a history of intravenous drug abuse. This article reviews the epidemiology of illicit drug abuse in the Middle East Gulf region, as well as the diagnosis and treatment of tricuspid valve endocarditis, and calls for all physicians in the region to be vigilant while dealing with intravenous drug abuse.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved. Key words: Drug abuser; Illicit drugs; Infective endocarditis; Tricuspid valve; Middle EastCore tip: It is presumed that tricuspid valve endocarditis is uncommon in the Middle East region. However, recently published global data indicate growing trends in the use of illicit drug abuse in the Middle East Gulf region. The Middle East Gulf States, currently a transit market, are also becoming a growing consumer market in view of the consumption patterns of substance abuse in the youth. This article reviews the epidemiology of illicit drug abuse in the Middle East Gulf region as well as diagnosis and treatment of tricuspid valve endocarditis.Panduranga P, Al-Abri S, Al-Lawati J. Intravenous drug abuse and tricuspid valve endocarditis: Growing trends in the Middle East Gulf region.

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A Rare Case of Septic Deep Vein Thrombosis in the Inferior Vena Cava and the Left Iliac Vein in an Intravenous Drug Abuser

Cited by 9 publications

References 20 publications

Deep Vein Thrombosis in Intravenous Drug Users: An Invisible Global Health Burden

Deep Vein Thrombosis in Intravenous Drug Users: An Invisible Global Health Burden

<p>Microbial Modulation of Coagulation Disorders in Venous Thromboembolism</p>

Intravenous drug abuse and tricuspid valve endocarditis: Growing trends in the Middle East Gulf region

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