Case report review of clindamycin use in a 62-year-old male with Neurofibromatosis type 1 and hematoma

Photo by CDC / Unsplash

Frontiers in Medicine Published May 14, 2026 Medically reviewed May 14, 2026 Study authors: Jing Zhang, Xin Pang, Yanan Meng, Qinlong Sun DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Note that acute pain or unexplained mass in NF1 suggests spontaneous hemorrhage requiring prompt imaging.

This source is a case report review focusing on a single 62-year-old male patient with Neurofibromatosis type 1. The clinical scenario involved the management of a hematoma through a combination of transcatheter arterial embolization, ultrasound-guided drainage, debridement, and targeted antibiotic therapy using clindamycin. No comparator group was reported for this individual case. The primary outcome of hematoma volume drained was approximately 3000 mL of old blood. Secondary outcomes included hematoma rupture and secondary infection, which were observed as adverse events in this specific instance. Follow-up duration was not reported. The review does not provide pooled effect sizes or data from a larger sample size. The authors emphasize that acute pain or an unexplained mass in an NF1 patient should raise immediate suspicion for spontaneous hemorrhage. This clinical presentation necessitates prompt vascular imaging and multidisciplinary intervention to improve outcomes. The certainty of these findings is limited by the small sample size inherent to a case report. Practice relevance is framed around the need for vigilance in NF1 patients presenting with these specific symptoms.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder in which vascular dysplasia can lead to rare, life-threatening spontaneous hemorrhage. We present the case of a 62-year-old male NF1 patient who presented with acute left lumbar pain and swelling without a history of trauma or anticoagulant use. Computed tomography (CT) revealed a large hematoma in the left lumbogluteal region and a presacral mass. Active bleeding from the left second lumbar artery and the subcostal artery was confirmed by digital subtraction angiography and successfully managed with transcatheter arterial embolization (TAE). The postoperative course was complicated by hematoma rupture and secondary infection. This was controlled with ultrasound-guided drainage (yielding approximately 3000 mL of old blood), debridement, and targeted antibiotic therapy (clindamycin). This case illustrates the rare yet complete clinical trajectory of spontaneous arterial rupture in NF1, from massive hematoma formation to infectious complications. It underscores that acute pain or an unexplained mass in an NF1 patient should raise immediate suspicion for spontaneous hemorrhage, necessitating prompt vascular imaging and multidisciplinary intervention to improve outcomes.