Tibialis posterior vein thrombosis in a patient after COVID-19 infection (Case Report)

Abstract :

Introduction:Isolated posterior tibial vein thrombosis is a rare and uncommon, with possible fatal complications. Covid-19 infections have been found to be associated with a high risk of thrombosis because it leads to endothelial damage and autoimmune mechanisms development microvascular thrombosis and occlusion. The incidence of venous thromboembolism is 14.8-20%, and its 16.5% with pulmonary embolism.Case report:We present a patient 60 years of age with comorbidities in the form of arrhythmia, arterial hypertension and chronic kidney disease. The patient had a Covid-19 infection with a moderate clinical stage. Within 60 days after the Covid-19 infection, the patient developed symptoms in the form of pain, difficulty with walking and swelling in the area bellow the right knee. The doppler ultrasound examination confirmed the presence of a thrombus in the lumen of a tibialis posterior vein. The patient was treated with anticoagulant therapy with low molecular heparin for 6 weeks, and then followed by oral antifiinolytic and antiagregatic therapy. On the following check-up doppler ultrasound showed us that thrombus masses were organized with partial recanalization without proximal progression and the patient was discharged without additional complications.Conclusion:Taking in the consideration the increased risk of intravascular thrombosis after a Covid-19 infection it is necessary to suspect thrombosis on time. Early doppler ultrasound examination of all deep veins in the legs can help in making the right diagnosis, application of adequate therapy and prevention of possible fatal complications.

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