SARS-CoV-2 Infection and Thrombosis: Phlegmasia Cerulea Dolens Presenting with Venous Gangrene in a Child.

A 12-year-old female with SARS-CoV-2 infection presented as phlegmasia cerulea dolens with venous gangrene.. Emergent mechanical thrombectomy was complicated by a massive pulmonary embolism and cardiac arrest for which extracorporeal cardiopulmonary resuscitation and therapeutic hypothermia were employed. Staged-ultrasound assisted catheter directed thrombolysis was employed for treatment of bilateral pulmonary emboli and the extensive lower extremity deep vein thrombosis while the patient received extracorporeal membrane oxygenation support. We highlight the need for heightened suspicion for occult SARS-CoV-2 infection among children presenting with unusual thrombotic complications.