Deep-vein thrombosis: An unusual complication of disseminated tuberculosis: A case report

Abstract

The occurrence of deep vein thrombosis (DVT) in tuberculosis (TB) is not uncommon in adults but is relatively rare in children. We report the case of a 13-year-old girl who presented with fever and cough for 2 months followed by acute onset of pedal edema. She was diagnosed with disseminated TB and DVT of the right femoral and common iliac veins. A timely diagnosis of DVT and prompt initiation of anticoagulant therapy along with antitubercular therapy, not only averted the rare, yet dangerous complication of thromboembolism but also hastened her path to recovery. The challenge of maintaining international normalized ratio in the desired range, was met by replacing Warfarin with a short-acting oral anticoagulant (Acenocoumarol) to overcome the enzyme-inducing action of Rifampicin. Screening tests to rule out autoimmune etiology of thrombosis; and tests done to rule out a hereditary predisposition to thrombosis, were normal. In the case of disseminated TB, a considerable degree of awareness is required, for the early detection and treatment of a potentially serious complication like DVT, to avoid the life-threatening complication of pulmonary embolism.

Keywords

• anticoagulation
• deep-vein thrombosis
• disseminated tuberculosis