Bilateral femoral nerve compression by iliopsoas hematoma in anticoagulated patient of COVID-19 pneumonia.

Abstract

^{Severe Covid-19, may lead to respiratory failure and ARDS, systemic thrombosis culminating in cardiovascular complications which are an important feature in the pathophysiology of the disease.}

^{64-year-old obese (BMI-38) female, a known hypertensive with type 2 diabetes and hyperlipidaemia, came with severe covid 19 pneumonia requiring mechanical ventilator.} 

^{During her course of illness she waa weaned off from ventilator but she developed neurological weakness in both lower limbs.}

^{Weakness was sudden in onset; there was no associated back pain or abdominal pain. On examination, in the upper limbs the power demonstrated was 4/5 in all muscle groups. Lower limbs power revealed left Hip flexor 2/5 right hip flexors 3/5, left hip abductor 2/5, right Hip abductor 3/5, right knee extensors 3/5, left knee extensor 2/5. Sensory system was essentially normal.  Reflexes were absent in both lower limbs and proximal muscle weakness was more profound as compared to distal group.}

On further workup iliopsoas hematoma was detected bilaterally compressing femoral nerve roots.

Patient did well on conservative management.