Popliteal deep vein thrombosis in a pediatric patient with Streptococcus viridans osteomyelitis: a case report

An 11-year-old male presented with severe pain in the left knee after a minor twisting injury. Magnetic resonance imaging (MRI) revealed a large fluid collection posterior to the distal femur. CT and intraoperative findings revealed left popliteal vein thrombosis. Irrigation and debridement were performed, and intraoperative cultures confirmed osteomyelitis due to pan-sensitive Streptococcus viridans (S. viridans). Treatment included antibiotic and anticoagulation therapy. At 6 months, the patient was asymptomatic and cleared for full activity. This case demonstrates that deep vein thrombosis (DVT) can occur with S. viridans osteomyelitis, a previously undescribed association. Clinicians should maintain suspicion for DVT with any causative organism in osteomyelitis.