Plantar Vein Thrombosis due to Busy Night Duty on Intensive Care Unit

A 32-year-old woman with severe foot pain came to our emergency
department after a busy night duty in hospital followed by an
extended sleep period. Physical examination revealed a discrete
swelling of the medial aspect of the right foot and a painful
plantar arch during digital examination. Magnetic resonance imaging
(MRI) with intravenous gadolinium showed filling efects in the
lateral plantar vein. Doppler sonography displayed noncompressible
structures in the plantar veins without flow signals, suggesting a
plantar vein thrombosis. Therapy was initiated with
low-molecular-weight heparin in combination with customized elastic
bandages for the lower leg. Follow-up sonography 6 weeks later
showed complete patency of the plantar veins. To our knowledge, we
present the first case of isolated plantar vein thrombosis
independent of trauma, surgery, or malignant disease, most probably
caused by a busy night duty on the intensive care unit (ICU)
followed by a prolonged sleeping period.