Case Report

Acute Pylephlebitis Following Gastrointestinal Infection: An Unrecognized Cause of Septic Shock

Authors: José Altamirano, MD, Laura Zapata, MD, Manuel Poblano, MD, Agustín Rodríguez, MD, Leonardo Camargo, MD, Belinda Martínez, MD, Ramón Bataller, MD, PhD

Abstract

Pylephlebitis is the septic thrombosis of the portal vein. Hypercoagulability and intra-abdominal sepsis are the main predisposing factors. A 25-year-old man presented to a primary health care center complaining of fever, epigastric pain, and jaundice. He was initially diagnosed with a gastrointestinal infection and alcoholic hepatitis and, due to his unstable clinical status, was referred to the emergency room. A diagnosis of acute pylephlebitis complicated with septic shock was made. Treatment with a wide-spectrum antibiotic and anticoagulation was initiated. Fifteen days later, recanalization of the portal vein was achieved and clinical status was improved. Pylephlebitis following gastrointestinal infection is a potential cause of septic shock.

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