ArticleAsymptomatic catheter-related venous thrombosis in a child with cystic fibrosis: When to treat?
Section snippets
Case Report
A 5-year-old Caucasian girl with CF (delta F508 homozygous) had a CVC (Celsite; Braun) inserted in the right subclavian vein for multiple courses of intravenous antibiotics after colonization by Pseudomonas aeruginosa. The CVC had been used for two years after insertion without complication. She presented to the emergency room with a one-day history of fever. Before this presentation, her CVC was flushed with heparin and saline at her routine checkup. On examination, she was normotensive with a
Discussion
VTE is a rare complication in children with CF, and therefore, outcome data are limited.2 More recently, the significant morbidity and mortality associated with CVC-related thrombosis have been recognized.5 This is associated with an increased risk of short-term complications that include CVC-related infection, CVC occlusion, the need for catheter replacement, and embolization. There are, however, few studies on the incidence of long-term complications. Complications such as no thrombus
Conclusion
The use of CVC in patients with CF is associated with an increased incidence of CVC-related VTE. The findings of this case report support the conservative management of CF patients with RAT who are hemodynamically stable and classified as low risk on echocardiography. We recommend close observation with radiological monitoring and removal of the CVC if possible.
Acknowledgments
The authors wish to acknowledge the staff in the Department of Pediatrics, ward 284, and Dr Motara in the department of Cardiology at Charlotte Maxeke Johannesburg Academic Hospital involved in the management of this patient.
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All authors have reviewed and agreed upon the manuscript content.
The authors have no conflicts of interest.
This manuscript has not been submitted elsewhere nor previously published.
Ethics: This study has been approved by the Human Research Ethics Committee of the University of the Witwatersrand (M-1080389).