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Pylephlebitis Caused by Bacillus subtilis and Fusobacterium nucleatum
Tatsuya Ochi1,2, Koji Oh1, Hiroki Konishi1
1Department of General Internal Medicine, Kobe City Medical Center West Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|July 12, 2023
Summary
A rare case of pylephlebitis, a serious infection of the portal vein, was successfully treated in a 90-year-old man. This case is notable as it was caused by Bacillus subtilis, an unusual pathogen for this condition.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Pylephlebitis, a rare but serious condition, involves thrombosis in the portal venous system, often presenting with fever of unknown origin.
- Prompt diagnosis and treatment are crucial for patient outcomes.
Observation:
- A 90-year-old male presented with prolonged fever and general malaise.
- Blood cultures revealed Bacillus subtilis and Fusobacterium nucleatum.
- Contrast-enhanced computed tomography confirmed thrombosis in the portal and superior mesenteric veins, diagnosing pylephlebitis.
Findings:
- The patient received antimicrobial therapy and anticoagulation.
- Successful treatment led to complete recovery.
- This case marks the first reported instance of pylephlebitis caused by Bacillus subtilis.
Implications:
- Pylephlebitis should be considered in the differential diagnosis of fevers of unknown origin, especially in elderly patients.
- Bacillus subtilis, though typically considered non-pathogenic, can cause severe infections like pylephlebitis.
- This case expands the known spectrum of pathogens associated with pylephlebitis.
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