Pylephlebitis Caused by Actinomyces Bacteremia

Abstract

Pylephlebitis is a thrombophlebitis of the portal vein or its branches, which usually occurs as a complication of intra-abdominal infections that are drained by the portal vein, most commonly as a result of diverticulitis or appendicitis. Diagnosis of pylephlebitis is achieved by visualizing a portal vein thrombosis in a patient with bacteremia or a recent intra-abdominal infection. Many microorganisms have been reported to cause this infection. However, Actinomyces has never been reported before as a cause of pylephlebitis. Here, we describe a case of a 56-year-old female who had pylephlebitis that was caused by Actinomyces bacteremia and was treated with intravenous antibiotics.

Keywords: actinomyces; portal vein thrombosis; pyelophlebitis; pylephlebitis.

Figure 1. An abdominal computed tomography scan with contrast showing an acute portal vein thrombosis (A) extending into the splenic vein (B) and segmental branches of the right and left hepatic lobes.

Figure 2. The patient’s white blood cell count (A) and temperature (B) trends during the hospital course.