DOI: 10.12890/2025_005752

Acute aortic thrombosis with limb ischemia in a patient with influenza A

Authors

  • Richard Osborne Division of Hospital Medicine, Department of Family Medicine, Sinai Health System, Toronto, Canada
  • Jayant Bhandari Division of General Internal Medicine, University Health Network/Sinai Health System, Toronto, Canada

richard.osborne@sinaihealth.ca

Keywords

Influenza A, thrombosis, limb ischemia

Abstract

Background: Influenza A is associated with venous and, less commonly, arterial thrombosis. Stroke and myocardial infarction comprise most arterial events, with only rare involvement of the aorta and peripheral arteries.
Case report: We report a 61-year-old male hospitalized for influenza A pneumonia and rhabdomyolysis who developed acute right lower limb ischemia on day 7 of his admission. Computed tomography scan of the abdomen revealed acute descending and infrarenal aortic thrombosis with embolic occlusion of the right popliteal artery. He underwent successful embolectomy and fasciotomy with good functional outcome.
Conclusion: This case demonstrates that Influenza A infection may provoke severe and unusual thrombotic events, even during the convalescent phase of illness. Prompt diagnosis and intervention are required to reduce the risk of limb amputation and mortality.

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References

  1. Sellers SA, Hagan RS, Hayden FG, Fischer WA 2nd. The hidden burden of influenza: A review of the extra-pulmonary complications of influenza infection. Influenza Other Respir Viruses 2017;11:372-393. doi: 10.1111/irv.12470
  2. Bunce PE, High SM, Nadjafi M, Stanley K, Liles WC, Christian MD. Pandemic H1N1 influenza infection and vascular thrombosis. Clin Infect Dis 2011;52:e14-17. doi: 10.1093/cid/ciq125
  3. Kwong JC, Schwartz KL, Campitelli MA, Chung H, Crowcroft NS, Karnauchow T, et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med 2018;378:345-353. doi: 10.1056/NEJMoa1702090
  4. Chow EJ, Rolfes MA, O’Halloran A, Anderson EJ, Bennett NM, Billing L, et al. Acute Cardiovascular Events Associated With Influenza in Hospitalized Adults: A Cross-sectional Study. Ann Intern Med 2020;173:605-613. doi: 10.7326/M20-1509
  5. Rubino R, Imburgia C, Bonura S, Trizzino M, Iaria C, Cascio A. Thromboembolic Events in Patients with Influenza: A Scoping Review. Viruses 2022;14:2817. doi: 10.3390/v14122817
  6. Yedlapati SH, Khan SU, Talluri S, Lone AN, Khan MZ, Khan MS, et al. Effects of Influenza Vaccine on Mortality and Cardiovascular Outcomes in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2021;10:e019636. doi: 10.1161/JAHA
  7. Hüzmeli C, Saglam M, Arikan A, Doner B, Akinci G, Candan F. Infrarenal Aorta Thrombosis Associated with H1N1 Influenza A Virus Infection. Case Rep Infect Dis 2016;2016:9567495. doi: 10.1155/2016/9567495
  8. Ishiguro T, Matsuo K, Fujii S, Takayanagi N. Acute thrombotic vascular events complicating influenza-associated pneumonia. Respir Med Case Rep 2019;28:100884. doi: 10.1016/j.rmcr.2019.100884
  9. Veizades S, Tso A, Nguyen PK. Infection, inflammation and thrombosis: a review of potential mechanisms mediating arterial thrombosis associated with influenza and severe acute respiratory syndrome coronavirus 2. Biol Chem 2021;403:231-241. doi: 10.1515/hsz-2021-0348
  10. Ward A, Sarraju A, Lee D, Bhasin K, Gad S, Beetel R, et al. COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort. PLoS One 2022;17:e0261786. doi: 10.1371/journal.pone.0261786

Published

2025-10-13

Issue

Vol. 12 No. 11 (2025)

Categories

How to Cite

1.
Osborne R, Bhandari J. Acute aortic thrombosis with limb ischemia in a patient with influenza A. EJCRIM [Internet]. 2025 Oct. 13 [cited 2026 Nov. 3];12(11). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5752