Two cases of portal vein thrombosis associated with Fusobacterium bacteraemia

Abstract

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.

Fusobacterium bacteremia presenting with inferior mesenteric vein thrombosis

“…11 The association between F. nucleatum and thrombosis, although less established, has been reported in several cases, including those of the iliac, portal, and mesenteric veins. [12][13][14][15] The T A B L E 1 Laboratory parameters with reference range.…”

“…septicemia 11 . The association between F. nucleatum and thrombosis, although less established, has been reported in several cases, including those of the iliac, portal, and mesenteric veins 12–15 . The spread of Fusobacterium to the large intestine and associated vasculature has been proposed to occur via a hematogenous route and translocation from the oral cavity to the intestine 1 .…”

Pylephlebitis Caused by Fusobacterium nucleatum in a Septuagenarian Healthy Caucasian Male: Atypical Presentation of Lemierre’s Syndrome

“…Evidence from a case report dating back to 2014 mentioned two cases involving portal vein thrombosis in context of Fusobacterium infections. The report mentioned that while Fusobacterium is known to induce platelet aggregation, thrombotic events outside of the head and neck are rare [ 8 , 14 ]. When they do occur, they are mainly seen in elderly patients and mortality can approach 25% [ 8 , 14 ].…”

“…The report mentioned that while Fusobacterium is known to induce platelet aggregation, thrombotic events outside of the head and neck are rare [ 8 , 14 ]. When they do occur, they are mainly seen in elderly patients and mortality can approach 25% [ 8 , 14 ].…”

Fusobacterium necrophorum subsp. necrophorum Liver Abscess with Pylephlebitis: An Abdominal Variant of Lemierre’s Syndrome

“…We searched the PubMed database for articles published in English using the following key words alone or in combination: pylephlebitis, suppurative portal vein thrombosis, Fusobacterium necrophorum, necrobacillosis, septic portal vein thrombosis, and infected portal vein thrombosis. Our search yielded 6 cases [7][8][9][10][11][12] (Table 2). e median age of patients was 37 years (ranging from 19 to 53 years) with 5:1 male to female ratio.…”