Pylephlebitis Complicated by Hepatic Abscesses due to Fusobacterium Nucleatum : A Case of Lemierre's Syndrome Variant and Literature Review.
Fouad JaberSaqr AlsakarnehJohn CampbellAmeen AwadWael T MohamedKaitlin WittlerHassan GhozWendell ClarkstonPublished in: ACG case reports journal (2023)
In gastrointestinal-variant Lemierre syndrome, Fusobacterium nucleatum can cause pylephlebitis and liver abscesses. We report a 62-year-old woman presenting with abdominal pain and altered mental status. Abdominal computed tomography showed hepatic lesions and thrombosis in the superior mesenteric and portal veins. Magnetic resonance cholangiopancreatography showed multiple cystic hepatic masses suspicious for abscess vs metastases. Malignancy workup was unrevealing. F. nucleatum grew on both blood and ultrasound-guided liver aspirate cultures. Twelve weeks of antibiotics and anticoagulants resolved her condition. Given the high mortality rates, prompt detection and treatment of gastrointestinal-variant Lemierre syndrome is critical to delivering quality, patient-centered care.
Keyphrases
- case report
- magnetic resonance
- ultrasound guided
- computed tomography
- abdominal pain
- fine needle aspiration
- contrast enhanced
- healthcare
- mental health
- palliative care
- cardiovascular events
- quality improvement
- positron emission tomography
- coronary artery disease
- cardiovascular disease
- risk factors
- pain management
- loop mediated isothermal amplification
- dual energy
- rare case
- affordable care act