Case Report Open Access

Identification and Management Implications of Fusobacterium Nucleatum Pylephlebitis

Shoja Rahimian1, Maria Labra2, Ian Garrahy1, Rebecca Brown1, Navdeep Sangha1, Urvi Patel 2 and Andrew Rettew1
  • 1 Department of Hematology and Oncology, Tower Health-Reading Hospital, United States
  • 2 Department of Internal Medicine, Tower Health-Reading Hospital, United States

Abstract

Suppurativethrombophlebitis of the portal vein, or pylephlebitis, is a rare infectious manifestation. Only few casesresulting from Fusobacterium species have been reported, demonstratingthe disease that is in some ways analogous to Lemierre’s syndrome, orsuppurative thrombophlebitis of the internal jugular vein. Of these, Fusobacteriumnucleatum represents an important subtype with unique colon cancer risk.With high mortality rates up to 32% being described in the past, promptidentification and treatment of pylephlebitis is necessary to avoid pooroutcomes with this condition, including complications such as intestinalischemia and portal hypertension. This condition typically presents alongsidebacteremia, for which antibiotic therapy typically targets anaerobic organismsof oral and intestinal mucosa, as well as Streptococcus species. The useof anticoagulation therapy for pylephlebitis is supported by limited data,which shows potential benefit for preventing worsening thrombosis and liveratrophy. Here we present a case of F. nucleatum pylophlebitis whopresented with related bacteremia and liver abscess after a dental infection,and treated with anaerobic coverage antibiotics including amoxicillinclavulanate until resolution of his hepatic abscess and with anticoagulationwith apixaban for a total of 6 months.

American Journal of Infectious Diseases
Volume 18 No. 3, 2022, 49-53

DOI: https://doi.org/10.3844/ajidsp.2022.49.53

Submitted On: 7 June 2022 Published On: 26 September 2022

How to Cite: Rahimian, S., Labra, M., Garrahy, I., Brown, R., Sangha, N., Patel , U. & Rettew, A. (2022). Identification and Management Implications of Fusobacterium Nucleatum Pylephlebitis. American Journal of Infectious Diseases, 18(3), 49-53. https://doi.org/10.3844/ajidsp.2022.49.53

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Keywords

  • Fusobacterium Nucleatum
  • Pylephlebitis
  • Suppurative Thrombophlebitis