[A case of a flapping infected XXXX in the internal jugular vein, septic pneumonias and heparin-induced thrombocytopaenia].

@entity1 @entity115 @entity882 @entity798 @entity358 @entity583 @entity3127 @entity715
We present a case of a 54 years old female @entity1 after anterior wall left ventricular @entity583 in 2005 who underwent coronary artery bypass graft (CABG) surgery requiring cannulation of the right internal jugular vein (IJV). She was admitted to a Department of @entity358 with left @entity3127 ( @entity3127 ) following 7 day treatment, with hemoptysis, dyspnoea and fevers. Duplex ultrasound (DUS) was used to diagnose flapping @entity715 in the right IJV, severe @entity882 and, in addition, progressing multiple infiltrates on X-ray a few days later. We empirically adjusted the treatment initiated in primary care and observed deterioration of the severe @entity882 during treatment with low molecular weight heparine. We diagnosed @entity882 ( @entity882 ) and, even though this indication was not included in our drug formulary, we initiated treatment with Arixtra (fondaparinux) 2.5 mg s.c. daily. Intensive conservative treatment was associated with significant clinical and laboratory improvement of the condition, significant regression of the IJV @entity715 as well as the finding on X-ray. The final effective antibiotic treatment lasted 20 ( @entity115 + @entity798 ) and 10 (clindamycin) days, respectively. Treatment with Arixtra (fondaparinux) continued in primary care and lasted a total of 65 days until normal thrombocyte levels were achieved, with gradual transition to oral anticoagulation treatment. The @entity1 was discharged to primary care on the 23rd day of hospitalization when she was stabilized, a febrile and her cardiopulmonary functions were compensated. We did not identify any case of treatment of jugular @entity715 and concurrent @entity882 with fondaparin anywhere in the international literature.
