Isolated mesenteric vein thrombosis associated with Fusobacterium is rare.Physicians should be aware regarding the association of Fusobacterium with thrombosis at various sites.
Background
Fusobacterium species are fastidious gram-negative anaerobes that frequently colonize the human oral cavity. Portal and mesenteric thrombosis associated with Fusobacterium are case-reportable; due to the rarity of these reports. Isolated mesenteric vein thrombosis from these species is even rarer.
Case presentation
A 59-year-old Caucasian male presented to the emergency department with a week of back pain and malaise. A CT abdomen and pelvis demonstrated an acute/early subacute partially occlusive thrombosis of the inferior mesenteric vein. Patient was discharged the same day with apixaban 5 mg twice daily. Attempts were made by the providers to contact the patient when one of the two bottles grew Fusobacterium species, but the patient didn’t respond. Patient presented to the hospital 2 weeks later with similar complaints. Patient was treated with intravenous piperacillin-tazobactam and discharged on amoxicillin-clavulanic acid for four weeks. A follow up CT in 2 months showed resolution of the thrombus. Patient completed 3 months of anticoagulation with apixaban.
Conclusion
We aim to increase physicians’ awareness regarding association of Fusobacterium to thrombosis at various sites. An early treatment of this condition with antibiotics and anticoagulation can prevent complications and result in favorable outcomes.
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