# A Multifactorial Presentation of Infection and Thrombosis: Temporal Clustering of Pneumonia, Hepatic Abscess, Bilateral Deep Vein Thromboses (DVTs), and Appendicitis in a Child

## TL;DR

A 13-year-old boy with blood-related traits experienced multiple infections and blood clots, highlighting the need for comprehensive care in complex pediatric cases.

## Contribution

This case report presents a rare, multifactorial combination of infections and thrombosis in a pediatric patient with genetic blood traits.

## Key findings

- The patient developed multiple severe infections and thromboses in a short time.
- Extensive evaluation ruled out inherited thrombophilias and autoimmune diseases.
- The case emphasizes the importance of multidisciplinary care for complex pediatric presentations.

## Abstract

Multisystem infectious and thrombotic presentations are rare in pediatric patients and often raise concern for an underlying immunologic or hematologic disorder. We report a case of a 13-year-old male with sickle cell trait and beta-thalassemia trait heterozygote who developed extensive bilateral deep vein thromboses (DVTs), a large hepatic abscess, right-sided pneumonia with empyema, and subsequently perforated appendicitis with intra-abdominal abscesses. The patient required broad-spectrum antimicrobial therapy, anticoagulation, percutaneous abscess drainage, and emergent surgical intervention. An extensive evaluation excluded inherited thrombophilias, autoimmune disease, and chronic granulomatous disease. The close temporal clustering of these events highlights a multifactorial process involving systemic inflammation, infection, and acquired hypercoagulability. This case underscores the importance of multidisciplinary management and longitudinal follow-up in pediatric patients presenting with recurrent or multifocal infections and thrombosis.