Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Infect Disord Drug Targets. 2021;21(4):634-636. doi: 10.2174/1871526520666200731180042.
Septic thrombophlebitis of the Superior Mesenteric Venous (SMV) is rarely accompanied by appendicitis, and symptoms are atypical, so the diagnosis is commonly delayed, resulting in it is associated with high mortality.
We report a case of neglected SMV septic thrombophlebitis is caused by appendicitis. The patient represented with fever, vague abdominal pain without rebound tenderness, and history of the consumption of contaminated water. Antibiotic initiated due to suspicious typhoid fever. Then typhoid fever was ruled out. Computed tomography (CT) scans revealed micro-abscess forming complicated appendicitis and the thrombus in SMV.
The patient underwent a laparoscopic appendectomy, during which retrocecal gangrened perforated appendix with a 2×2 cm abscess was drained. Based on positive culture with ESBL organism meropenem was initiated. Appendectomy and treatment with broad- -spectrum antibiotics and anticoagulation led to a full recovery.
肠系膜上静脉（SMV）的感染性血栓性静脉炎很少伴有阑尾炎，且症状不典型，因此常导致诊断延迟，从而导致高死亡率。
我们报告了一例因阑尾炎而被忽视的 SMV 感染性血栓性静脉炎病例。患者表现为发热、腹痛不明显且无反跳痛，并曾饮用受污染的水。由于疑似伤寒而开始使用抗生素。随后排除了伤寒。计算机断层扫描（CT）显示形成复杂阑尾炎和 SMV 血栓的微脓肿。
患者接受了腹腔镜阑尾切除术，在手术中发现阑尾后位坏疽穿孔，伴有 2×2cm 脓肿，并进行了引流。基于阳性培养和产 ESBL 菌，使用美罗培南进行治疗。阑尾切除术以及广谱抗生素和抗凝治疗使患者完全康复。
