Article Text

Download PDFPDF
Spontaneous pyohaemothorax in a teenager with von Willebrand disease: a case report and review of literature
  1. Vaishnavi Divya Nagarajan1,1,
  2. Asha Shenoi2,
  3. Lucy Burgess1 and
  4. Vlad C Radulescu3
  1. 1Pediatrics, University of Kentucky, Lexington, Kentucky, USA
  2. 2Pediatric Critical Care, University of Kentucky, Lexington, Kentucky, USA
  3. 3Pediatric Hematology - Oncology, University of Kentucky, Lexington, Kentucky, USA
  1. Correspondence to Dr Vaishnavi Divya Nagarajan; divya.nagaraj{at}


An 18-year-old man with a history of type 3 von Willebrand disease (VWD) presented with a spontaneous pyohaemothorax. Type 3 VWD may present with both mucocutaneous and deep-seated bleeds, such as visceral haemorrhages, intracranial bleeds and haemarthrosis. There have been very few cases described in children of spontaneous pyohaemothorax. Management of this patient was challenging due to risks of bleeding following surgical drainage, requiring constant replacement with von Willebrand factor concentrate, while monitoring factor VIII levels to balance the risks of thrombosis.

  • haematology (incl blood transfusion)
  • paediatrics (drugs and medicines)

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors VDN coauthored this article with AS, LB and VCR. There are no prior publications or submissions with any overlapping information. The idea for the article was conceived by all four authors. VDN did the literature search. VDN wrote the initial draft and the coauthors revised the complete draft multiple times. As the first and corresponding author, VDN will be the guarantor and responsible for all further communications. The case was managed by all the authors in different roles.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.