Kalbitz Sven, Ermisch Jörg, Schmidt Jonathan M, Wallstabe Ingo, Lübbert Christoph
Department of Infectious Diseases, Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Leipzig, Germany.
Department of Gastroenterology, Hepatology, Diabetology and Endocrinology, St. Georg Hospital, Leipzig, Germany.
Case Rep Gastroenterol. 2021 Jul 6;15(2):598-602. doi: 10.1159/000517094. eCollection 2021 May-Aug.
Portal vein thrombosis (PVT) is a rare disease with an incidence of 0.7/100,000 inhabitants per year. Septic PVT (pylephlebitis) usually occurs secondary to infection in the anatomic region drained by the portal venous system. We report on a 76-year-old German male who was admitted with a history of recurrent fever and acute renal failure. Blood cultures taken on admission showed , as well as after an extended incubation period of 90 h. In addition, infection with spp. was diagnosed serologically. Computerized tomography of the abdomen revealed an extensive PVT along with signs of colonic diverticulitis. Symptoms resolved under prolonged antimicrobial therapy with beta-lactams and adequate heparinization. A myeloproliferative disorder could be excluded. There was no evidence of an underlying coagulation disorder. Imaging controls showed an almost complete resolution of the PVT after 6 months of anticoagulation therapy. To the best of our knowledge, this is the first report of such an "unhappy triad," which includes atypical manifestations of leptospirosis and involvement of other intestinal bacteria.
门静脉血栓形成（PVT）是一种罕见疾病，年发病率为每10万居民0.7例。化脓性门静脉血栓形成（门静脉炎）通常继发于门静脉系统引流的解剖区域的感染。我们报告了一名76岁的德国男性，他因反复发热和急性肾衰竭病史入院。入院时采集的血培养在90小时的延长培养期后显示……以及……此外，血清学诊断为……菌属感染。腹部计算机断层扫描显示广泛的门静脉血栓形成以及结肠憩室炎的迹象。在使用β-内酰胺类药物进行长期抗菌治疗和充分肝素化的情况下，症状得到缓解。可以排除骨髓增殖性疾病。没有潜在凝血障碍的证据。影像学检查显示抗凝治疗6个月后门静脉血栓形成几乎完全消退。据我们所知，这是关于这种“不幸三联征”的首次报告，其中包括钩端螺旋体病的非典型表现和其他肠道细菌的感染。
