Tucked Away: An Infected Thrombus

Hubbard, Elizabeth; Wise, Eric S.; Hubbard, Bradley; Girard, Steven; Kong, Bobby; Moudgal, Varsha

doi:10.1016/j.amjmed.2016.01.042

Cited by 11 publications

(10 citation statements)

References 9 publications

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“…The formation of thrombi stimulated by a COVID-19 infection might also create a perfect breeding ground for bacteria [12]. A thrombus can be infected via a distant, typically unidentified source of bacteremia and the poor antibiotic penetration of large size thrombi carry the risk of recurrent episodes of bacteremia [12]. In line with this hypothesis might micro-embolization of thrombi in the pulmonary vascular bed also explain the higher incidence of pneumonia in COVID-19 patients with VTE.…”

Section: Discussionmentioning

confidence: 98%

“…reverse causation), for instance: simply by prolonging hospitalization. The formation of thrombi stimulated by a COVID-19 infection might also create a perfect breeding ground for bacteria [12]. A thrombus can be infected via a distant, typically unidentified source of bacteremia and the poor antibiotic penetration of large size thrombi carry the risk of recurrent episodes of bacteremia [12].…”

Section: Discussionmentioning

confidence: 99%

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Bacterial surinfection and venous thromboembolism in critically ill ICU patients with COVID-19: What is the relationship?

Stessel

Peeters

Bruckers

et al. 2021

Thrombosis Research

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2020 will forever be remembered as the year marked by the worst global health crisis in a century due to the current Coronavirus disease 2019 (COVID-19/SARS-CoV-2) pandemic. The vast majority of patients with severe COVID-19 initially presents with single organ failure, i.e. hypoxemic respiratory failure [1]. A growing body of research suggests that severe COVID-19 infection, despite routinely low dose pharmacological venous thromboembolism (VTE) prophylaxis with Low Molecular Weight Heparins (LMWH), is associated with a high incidence of thromboembolic phenomena [2,3]. Acute bacterial infection is another well-described cause of venous thromboembolism [4,5]. Bacterial coinfection is relatively infrequent in hospitalized patients with COVID-19 but more common in critically ill patients (8.1%) [6]. We wondered if there is, independently from the causal relationship between SARS-CoV-2 and elevated thrombosis risk, also a superimposed clear association between bacterial co-infection in COVID-19 patients admitted to the ICU and thrombosis risk. In view of the fact that many of those patients suffer from multiple episodes of co-infections, it would be additionally interesting to assess whether an association between total number of co-infection episodes and thrombosis risk could be found. Therefore, we investigated if there is a relationship between the number of diagnosed VTEs and the number of episodes of bacterial co-infections in COVID-19 patients admitted to the ICU.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Bacterial surinfection and venous thromboembolism in critically ill ICU patients with COVID-19: What is the relationship?

Stessel

Peeters

Bruckers

et al. 2021

Thrombosis Research

View full text Add to dashboard Cite

show abstract

“…The diagnosis of infected thrombus is primarily clinical and by Doppler ultrasound. Histopathology, which could be confirmatory, can be obtained if surgical management is warranted [ 25 ]. Our patient had consecutive blood cultures positive for S. lugdunensis, two of them were after the antibiotic was changed based on sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus lugdunensis Bacteremia with an Infected Aortic Thrombus in a Preterm Infant

Mani

Chandrasekharan

2022

Children

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Staphylococcus lugdunensis is a rare cause of late-onset sepsis in preterm infants. To our best knowledge, we report the fourth case of a male preterm infant who developed fulminant late-onset sepsis due to Staphylococcus lugdunensis with persistent bacteremia secondary to an infected aortic thrombus confirmed with two positive blood cultures. Our patient was an extremely low birth weight growth-restricted infant born at 27 weeks gestation and initially required an umbilical arterial catheter for blood pressure and blood gas monitoring. The course of this neonate was complicated by severe respiratory distress syndrome that evolved into chronic lung disease along with multiple episodes of tracheitis. Hemodynamically, the infant had a significant patent ductus arteriosus, and an episode of medical necrotizing enterocolitis followed by Staphylococcus lugdunensis septicemia. He was diagnosed with an infected aortic thrombus, probably the occult focus responsible for the persistent bacteremia. After a 6-week course of intravenous antibiotics and 4-week course of anticoagulant therapy, the infant responded and recovered without complications.

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“…These intracardiac thrombi can be sterile or infected. Usually, in cases of infected thrombosis, there are persistent positive blood cultures despite adequate antibiotic therapy [24]. Moreover, these patients are extremely sick and usually require surgical management [24].…”

Section: Discussionmentioning

confidence: 99%

Enterococcus durans Cardiac Implantable Electronic Device Lead Infection and Review of Enterococcus durans Endocarditis Cases

et al. 2022

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Introduction: Cardiac implantable electronic device (CIED) infections present a growing problem in medicine due to a significant increase in the number of implanted devices and the age of the recipient population. Enterococcus spp. are Gram-positive, facultative anaerobic, lactic acid bacteria; they are relatively common pathogens in humans, but uncommon as the cause of CIED lead infections. Only eight cases of Enterococcus durans endocarditis have been reported in the literature thus far; however, there are no reported cases of Enterococcus durans CIED lead infection. Case presentation: A 58-year-old gentleman with a previously implanted St. Jude Medical single-chamber implantable cardioverter–defibrillator (ICD) due to tachy/brady arrhythmias presented with nonspecific constitutional symptoms (i.e., low-grade fevers, chills, fatigue), and was found to have innumerable bilateral pulmonary nodules via computed tomography angiography of the chest. Many of these pulmonary nodules were cavitated and highly concerning for septic pulmonary emboli and infarcts. Within 24 h from presentation, blood cultures in all four culture bottles grew ampicillin- and vancomycin-susceptible Enterococcus durans. Transthoracic echocardiogram confirmed vegetations on the ICD lead in the right ventricle. The patient underwent laser extraction of the ICD lead with generator removal and recovered completely after a 6-week intravenous antibiotic course. Conclusion: To our knowledge, this is the first report of CIED lead infection caused by Enterococcus durans. In this case, management with antibiotics along with ICD lead extraction led to complete recovery. Clinicians should be aware of this rare but potentially devastating infection in patients with native and artificial valves, but also in those with CIEDs.

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Tucked Away: An Infected Thrombus

Cited by 11 publications

References 9 publications

Bacterial surinfection and venous thromboembolism in critically ill ICU patients with COVID-19: What is the relationship?

Bacterial surinfection and venous thromboembolism in critically ill ICU patients with COVID-19: What is the relationship?

Staphylococcus lugdunensis Bacteremia with an Infected Aortic Thrombus in a Preterm Infant

Enterococcus durans Cardiac Implantable Electronic Device Lead Infection and Review of Enterococcus durans Endocarditis Cases

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