Septic pylephlebitis associated with Enterobacter cloacae septicemia

• Published in: Journal des maladies vasculaires Vol. 35; no. 1; p. 31
• Main Authors: Amezyane, T, Abouzahir, A, El Kharrass, A, Bassou, D, Fatihi, J, Hammi, S, Mahassin, F, Ghafir, D, Ohayon, V
• Format: Journal Article
• Language: French
• Published: France 01.02.2010
• Subjects: Abdominal Pain - etiology; Adult; Anti-Bacterial Agents - therapeutic use; Anticoagulants - therapeutic use; Bacteremia - complications; Bacteremia - drug therapy; Bacteremia - microbiology; Ceftriaxone - administration & dosage; Ceftriaxone - therapeutic use; Community-Acquired Infections - complications; Community-Acquired Infections - drug therapy; Community-Acquired Infections - microbiology; Drug Therapy, Combination; Enoxaparin - therapeutic use; Enterobacter cloacae - isolation & purification; Enterobacteriaceae Infections - complications; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - microbiology; Fever - etiology; Gentamicins - administration & dosage; Gentamicins - therapeutic use; Humans; Magnetic Resonance Imaging; Male; Metronidazole - administration & dosage; Metronidazole - therapeutic use; Portal Vein; Tomography, X-Ray Computed; Venous Thrombosis - etiology
• ISSN: 2214-8116
• DOI: 10.1016/j.jmv.2009.09.005

Septic pylephlebitis or purulent thrombosis of the portal venous system generally results from a progressive extension of suppurated thrombophlebitis, secondary to an intrabdominal infection. Germs most often found are Escherichia coli and Streptococcus, isolation of Enterobacter cloacae is unusual. We report a particular observation of septic pylephlebitis associated with E. cloacae bacteremia, without biliary, digestive or pancreatic lesion on the CT-scan. The antibiotic sensitivity pattern of the isolated germ and the negative epidemiologic investigation pled in favour of community acquired infection. The infection resolved with antibiotics and anticoagulation, followed by total repermeation of the portal system.