Fusobacterium necrophorum infection associated with portal vein thrombosis

Redford, Michelle R; Ellis, Richard J.; Rees, Colin

doi:10.1099/jmm.0.46080-0

Cited by 15 publications

(12 citation statements)

References 9 publications

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“…Pylephlebitis is a secondary phenomenon subsequent to sepsis affecting parts of the gastrointestinal tract drained by the portal vein or structures adjacent to it. Recognized causes of pylephlebitis include perforated appendicitis, diverticulitis, inflammatory bowel disease, intestinal obstruction, infected pancreatic necrosis, gastric ulceration, sepsis of the biliary tree, and infection with clostridia, fusobacteria (as in Lemierre syndrome characterized by acute oropharingeal infection and thrombophlebitis of the internal jugular vein) or cytomegalovirus [2,[7][8][9][10][11][12]. The exact etiology of pylephlebitis in our patient was not established.…”

Section: Discussionmentioning

confidence: 90%

Fatal hemorrhage due to thrombosis and rupture of the portal vein and hepatic artery

Ferkolj

Vrh-Jermancic

Štabuc

2009

Wien Klin Wochenschr

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Portal vein thrombosis is a fairly common clinical condition that is usually not fatal but may give rise to serious complications. We report the case of a woman who was always in good health until the age of 50, when she developed acute gastroenterocolitis with inflammation of the portal vein (pylephlebitis or septic portal thrombophlebitis), resulting in thrombus formation, rupture of the vascular wall and exsanguination. At autopsy, no signs of thrombosis or inflammation were found elsewhere in the body and there was no evidence of any other disease or abnormality. Pylephlebitis may occur following intra-abdominal sepsis from any source. It is a rare condition that carries a high mortality. Rupture of the inflamed portal vein and possibly the adjacent artery is an extremely rare complication.

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Section: Discussionmentioning

confidence: 90%

Fatal hemorrhage due to thrombosis and rupture of the portal vein and hepatic artery

Ferkolj

Vrh-Jermancic

Štabuc

2009

Wien Klin Wochenschr

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“…When they do occur, they are mainly seen in elderly patients and mortality can approach 25 % (Hagelskjaer & Prag, 2000). Portal vein thrombosis in association with both F. necrophorum and F. nucleatum has been reported (Bultink et al, 1999;Hamidi et al, 2008;Redford et al, 2005). The source of bacteraemia in these patients is not always evident, and it has been suggested that in cases of Fusobacterium bacteraemia of unknown origin, portal vein thrombosis should be ruled out (Hamidi et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Two cases of portal vein thrombosis associated with Fusobacterium bacteraemia

DePetrillo

2014

JMM Case Reports

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This report presents two cases of Fusobacterium bacteraemia associated with portal vein thrombosis. A 63-year-old man with a history of hypercholesterolaemia and nephrolithiasis was admitted to the hospital with fever and abdominal pain. A computed tomography (CT) scan revealed thrombosis of the posterior right portal vein. Blood cultures were positive for Fusobacterium nucleatum. The second case was a 53-year-old man with alcoholic steatohepatitis admitted with fever, chills and abdominal pain. A CT scan revealed right portal vein thrombosis and Fusobacterium necrophorum was isolated from his blood cultures. Both patients were successfully treated with intravenous ertapenem 1 g day -1 for 4 weeks with resolution of symptoms. These case reports underscore the importance of considering the diagnosis of portal vein thrombosis in patients with Fusobacterium bacteraemia of unclear aetiology.

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“…Haemolysin lyses erythrocytes and, in this way, reduces oxygen transport to the site of the infection [7]. F. Necrophorum produces haemagglutinin, which causes platelet aggregation that can lead to diffuse intravascular coagulation and thrombocytopenia, but also to thrombosis [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence is approximately one per million per year, but it has a mortality of 5-10% [7,9,10]. Before the development of antibiotics this syndrome had a rapidly fatal course.…”

Section: Discussionmentioning

confidence: 99%