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Fusobacterium nucleatum Bacteremia Presenting as Portal Vein Thrombosis
1)Clinical Infectious Disease Center, Jichi Medical University Hospital, 2)Department of General Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, 3)Juntendo University Urayasu Hospital, 4)Center for Global Health, Mito Kyodo General Hospital, University of Tsukuba
Ayaka ISHIHARA1), Kaoru SHIMADA2), Tomoharu SUZUKI3), Noriko TAKAMURA4), Katsushige TADA4), Haruhiko ISHIOKA4) & Harumi GOMI4)
(Received October 24, 2018)
(Accepted August 30, 2019)
Key words: Fusobacterium nucleatum, portal vein thrombosis, pylephlebitis

Fusobacterium species have been notable as a cause of Lemierre's syndrome. Portal vein thrombosis due to Fusobacterium bacteremia is uncommon. It is sometimes referred to as Lemierre's syndrome variant of the gut. We describe herein an 87-year-old man who presented with a fever and chills. Computerized axial tomography with contrast material revealed portal vein thrombosis and a sign of ascending colon diverticulitis. Blood cultures turned positive 75 hours after admission, and Fusobacterium nucleatum was isolated in two sets of anaerobic bottles. He received intravenous antimicrobial therapy with anticoagulation therapy. However, anticoagulation therapy was discontinued because of hematochezia. He underwent colonoscopy and colon cancer in an early stage was diagnosed. We discuss the entry site of F. nucleatum including a possible association between F. nucleatum infection and colon cancer. In addition, a literature review was performed and a total of 17 patients with pylephlebitis due to Fusobacterium species was identified. The characteristics of patients, complications, entry sources, antimicrobial therapies, anticoagulation therapies, and patients' outcomes are summarized.

[ Kansenshogaku Zasshi 93: 768-774, 2019 ]

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