Intraluminal gas in deep vein thrombosis associated with Rhodotorula mucilaginosa fungemia and Prevotella intermedia bacteremia: a unique clinical case report and literature overview.

Abstract

Intravenous drug use (IVDU) is associated with multiple complications, including thrombus and infection with rare pathogens. Here, we present a unique case of septic thrombophlebitis with gas present within the lumen of the thrombus that was identified from an otherwise unassuming wound via point-of-care ultrasound (POCUS). In conjunction with past literature, this finding raises the possibility of POCUS detection of intraluminal gas as a sensitive indicator of septic thrombophlebitis. Furthermore, the patient's polymicrobial infection with Rhodotorula mucilaginosa and Prevotella intermedia expands the types of pathogens that should be suspected in IVDU-related infections; this case is the first reported Rhodotorula mucilaginosa infection of an IVDU patient with no known immunodeficiency. Though rare, greater attention should be paid to this emerging pathogen in IVDU. This case highlights the importance of a low threshold for using POCUS in patients with IVDU and other risk factors for complex infections.