case_images: PMC9897686_01
case_images: PMC9897686_02
case_images: PMC9897686_03
case_images: Local swelling and erythema in the neck region six days after venous punctures.
case_images: cureus-0015-00000033456-i01.jpg
case_images: PMC9897686_03_cureus-0015-00000033456-i01.jpg
case_images: FIG1
case_images: During that period, the patient's neck developed local inflammatory signs, with growing localised swelling, tenderness, and redness around the previous CVC puncture sites (Figure 1).
case_images: Axial view of the CT scan of the thorax (A) Six days after CVC puncture, this image shows densification of the structural adipose cell environment with multifocal impairment of the normal anatomical cleavage between structures (blue arrow) in the superior mediastinum. (B) The same location after 15 days of treatment with corticosteroids, with almost no changes.
case_images: cureus-0015-00000033456-i02.jpg
case_images: PMC9897686_10_cureus-0015-00000033456-i02.jpg
case_images: FIG2
case_images: The CT scan revealed clear improvement, with virtually no signs of haematoma or oedema (Figure 2B and 3B).
case_images: Coronal view of the CT scan of the neck (A) Six days after the CVC puncture, this image shows densification of the structural adipose cell environment with multifocal impairment of the normal anatomical cleavage between structures (blue arrow) below the sternocleidomastoid muscle. (B) The same location after 15 days of treatment with corticosteroids, with almost no changes.
case_images: cureus-0015-00000033456-i03.jpg
case_images: PMC9897686_10_cureus-0015-00000033456-i03.jpg
case_images: FIG3
case_images: The CT scan revealed clear improvement, with virtually no signs of haematoma or oedema (Figure 2B and 3B).
case_images: PMC9897686_04
case_images: Local swelling and erythema a few hours after a venous puncture in the patient's right arm.
case_images: cureus-0015-00000033456-i04.jpg
case_images: PMC9897686_04_cureus-0015-00000033456-i04.jpg
case_images: FIG4
case_images: On that same day, the patient complained about pain in his right upper arm, with local swelling and erythema around a site that had previously been punctured on the extensor surface of the right arm (Figure 4).
case_images: An erythematous-violaceous plaque of circular configuration with well-defined borders, an irregular, cerebriform surface, and a surrounding erythematous halo.
case_images: cureus-0015-00000033456-i05.jpg
case_images: PMC9897686_04_cureus-0015-00000033456-i05.jpg
case_images: FIG5
case_images: PMC9897686_05
case_images: Histological slide from affected skin revealing a dense neutrophilic infiltrate in the reticular dermis extending to the hypodermis (arrow).
case_images: cureus-0015-00000033456-i06.jpg
case_images: PMC9897686_05_cureus-0015-00000033456-i06.jpg
case_images: FIG6
case_images: The histopathological study of the biopsy, after performing hematoxylin and eosin staining, showed confluent epidermal necrosis and keratinocyte pallor and oedema in the lower half of the spinous layer and basal layer; prominent oedema in the superficial dermis, with subepidermal dislocation; and a dense infiltrate of neutrophils with perivascular accentuation and leukocytoclasis, without evidence of vasculitis, extending to the hypodermis (Figure 6).
case_images: PMC9897686_06
case_images: PMC9897686_07
case_images: PMC9897686_08
case_images: PMC9897686_09
case_images: PMC9897686_10
case_images: Axial view of the CT scan of the thorax (A) Six days after CVC puncture, this image shows densification of the structural adipose cell environment with multifocal impairment of the normal anatomical cleavage between structures (blue arrow) in the superior mediastinum. (B) The same location after 15 days of treatment with corticosteroids, with almost no changes.
case_images: cureus-0015-00000033456-i02.jpg
case_images: PMC9897686_10_cureus-0015-00000033456-i02.jpg
case_images: FIG2
case_images: The CT scan revealed clear improvement, with virtually no signs of haematoma or oedema (Figure 2B and 3B).
case_images: Coronal view of the CT scan of the neck (A) Six days after the CVC puncture, this image shows densification of the structural adipose cell environment with multifocal impairment of the normal anatomical cleavage between structures (blue arrow) below the sternocleidomastoid muscle. (B) The same location after 15 days of treatment with corticosteroids, with almost no changes.
case_images: cureus-0015-00000033456-i03.jpg
case_images: PMC9897686_10_cureus-0015-00000033456-i03.jpg
case_images: FIG3
case_images: The CT scan revealed clear improvement, with virtually no signs of haematoma or oedema (Figure 2B and 3B).
case_images: PMC9897686_11