Spontaneous pyohaemothorax in a teenager with von Willebrand disease: a case report and review of literature

Vaishnavi Divya Nagarajan; Asha Shenoi; Lucy Burgess; Vlad C Radulescu

doi:10.1136/bcr-2021-241613

Spontaneous pyohaemothorax in a teenager with von Willebrand disease: a case report and review of literature

BMJ Case Rep. 2021 Aug 17;14(8):e241613. doi: 10.1136/bcr-2021-241613.

Authors

Vaishnavi Divya Nagarajan^{1

2}, Asha Shenoi³, Lucy Burgess², Vlad C Radulescu⁴

Affiliations

¹ Pediatrics, University of Kentucky, Lexington, Kentucky, USA divya.nagaraj@uky.edu.
² Pediatrics, University of Kentucky, Lexington, Kentucky, USA.
³ Pediatric Critical Care, University of Kentucky, Lexington, Kentucky, USA.
⁴ Pediatric Hematology - Oncology, University of Kentucky, Lexington, Kentucky, USA.

Abstract

An 18-year-old man with a history of type 3 von Willebrand disease (VWD) presented with a spontaneous pyohaemothorax. Type 3 VWD may present with both mucocutaneous and deep-seated bleeds, such as visceral haemorrhages, intracranial bleeds and haemarthrosis. There have been very few cases described in children of spontaneous pyohaemothorax. Management of this patient was challenging due to risks of bleeding following surgical drainage, requiring constant replacement with von Willebrand factor concentrate, while monitoring factor VIII levels to balance the risks of thrombosis.

Keywords: haematology (incl blood transfusion); paediatrics (drugs and medicines).

Publication types

Case Reports
Review

MeSH terms

Adolescent
Factor VIII
Hemarthrosis
Hemorrhage / etiology
Humans
Male
von Willebrand Diseases* / complications
von Willebrand Factor

Substances

von Willebrand Factor
Factor VIII