Abstract Background: Upper extremity deep vein thrombosis (UEDVT) is an uncommon but potentially serious condition that can mimic cellulitis and lead to delayed diagnosis. We report a rare case of extensive right upper extremity deep vein thrombosis in a healthy 22-year-old man, initially misdiagnosed as cellulitis. The patient presented with progressive swelling, erythema, and mild pain of the right upper limb without fever. Physical examination revealed diffuse edema, warmth, prominent superficial veins, and preserved distal pulses. After failure to improve on antibiotics, Doppler ultrasound revealed occlusive thrombosis involving the right subclavian, axillary, and brachial veins. Pulmonary embolism was excluded by computed tomography angiography. A thorough evaluation showed no history of trauma, vigorous activity, central venous catheterization, or malignancy. Thrombophilia testing was negative. Thoracic outlet syndrome was considered; however, no fixed compression was identified on duplex imaging. Dynamic venous compression was not fully excluded as advanced provocative imaging such as contrast venography was not performed. The patient was treated with anticoagulation alone and achieved full recovery, with complete recanalization at six months and no recurrence at one year. This case highlights the importance of early vascular imaging in patients with atypical limb swelling and emphasizes that UEDVT should be considered even in low-risk individuals.
Abuzahra et al. (Wed,) studied this question.