Case Report

A Rare Twist of the Forgotten Disease: A Case of Fusobacterium necrophorum Sepsis with Portomesenteric Thrombosis and a Review of the Literature

Table 2

Thrombus extent, management, and outcomes in patients with Fusobacterium-spp.-associated pylephlebitis.

Author (year)Clot extentAntibiotic regimenAnticoagulation agentAnticoagulation durationOutcomes

Presented casePV and SMVI: vancomycin and meropenem
F: ertapenem (2 weeks)
UFH and apixaban3 monthsRecovery and elective sigmoidectomy 2 years later
Abdallah et al. (2020)PV, SMV, and IMVI: meropenem
F: ertapenem (1 month)
UFH and warfarin6 monthsRecovery and asymptomatic at 6-month follow-up
Hamera et al. (2019)PVI: meropenem
F: ceftriaxone/metronidazole (1 month)
Enoxaparin1 monthRecovery and no long-term follow-up
Le Roux et al. (2006)SMVF: amoxicillin-clavulanate and metronidazole (10 months)UFHHospitalizationRecovery, 10-month follow-up, and abdominal US with chronic PVT
Mellor et al. (2017)IMVI: piperacillin-tazobactam
F: ertapenem (1 month)
UFHHospitalizationRecovery, 1-month follow-up, and CT with PVT resolution
Moore et al. (2016)Right PVI: piperacillin-tazobactam
F: metronidazole (4 weeks)
Enoxaparin and warfarin6 monthsRecovery and asymptomatic at follow-up
Radovanovic et al. (2019)PVI: ceftriaxone/metronidazole
F: amoxicillin-clavulanate (2 weeks)
Enoxaparin and warfarin3 monthsRecovery and asymptomatic at 1-month follow-up
Rahmati et al. (2017)PVI: ertapenem
F: ceftriaxone/metronidazole (2 months), ampicillin-clavulanate (2 months)
EnoxaparinRecovery and 4-month follow-up CT with cavernous PV transformation
Tharu and et al. (2020)Superior right hepatic veinI: vancomycin/ceftriaxone/metronidazole
F: ceftriaxone/metronidazole (6 weeks)
NoneRecovery and 1-month CT with PVT resolution
Akhrass et al. (2015)Main PV at the confluenceI: piperacillin-tazobactam
F: Clindamycin (6 weeks)
UFH and warfarin6 weeksRecovery and follow-up not reported
Zheng et al. (2014)Right hepatic veinI: cefepime
F: clindamycin
Enoxaparin and warfarinRecovery and 2-month follow-up
Hamidi et al. (2008) case 1SMVI: amoxicillin-clavulanate (during admission)
F: —
LMWH and fluindione6 monthsRecovery and 5-month follow-up US with PVT resolution
Hamidi et al. (2008) case 2SMVNoneNoneNoneLeft against medical advice
Soo et al. (1999)PV andSMVI: ciprofloxacin/metronidazole/penicillin
F: amoxicillin-clavulanate/metronidazole (6 weeks)
UFH and warfarin6 monthsRecovery and 4-month MRI with resolved PVT
Shahani et al. (2011)Left and right PV, SMV, and splenic veinI: vancomycin/meropenem
F: tigecycline (4 weeks)
NoneNoneRecovery and 2-month CT with cavernous PV transformation
Clarke et al. (2003)PV and SMVF: benzylpenicillin/metronidazole/ciprofloxacin (6 weeks)UFH and warfarinIndefiniteRecovery and 7-weeks US with PVT improvement
Redford et al. (2005)PVI: metronidazole/benzylpenicillin
F: clindamycin (5 weeks)
LMWH and warfarin3 monthsRecovery and 3-months follow-up
Bultink et al. (1999)PVI: imipenem
F: penicillin G (6 weeks)
IV heparinHospitalizationRecovery and 2-month US with chronic PVT
Verna et al. (2004)Left PVF: clindamycin (2 weeks)NoneNoneRecovery and 6-month CT with chronic PVT and left hepatic atrophy
El Braks et al. (2004)PV and SMVF: piperacillin-tazobactam (2 weeks) and ofloxacin (3 weeks)UFH and fluindione9 monthsRecovery and CT at follow-up (not reported) with chronic PVT
Etienne et al. (2001)PVF: cefotaxime and metronidazole (2 weeks) and metronidazole (2 weeks)LMWH3 weeksRecovery and 5-week US with resolution
Schweigart et al. (2005)PVF: clindamycinWarfarinIndefinitelyRecovery and no long-term follow-up

Abbreviations: I: initial regimen, F: final regimen, PV: portal vein, SMV: superior mesenteric vein, IMV: inferior mesenteric vein, CT: computed tomography, US: ultrasound, MRI: magnetic resonance imaging, UFH: unfractionated heparin, LMWH: low-molecular-weight heparin, PVT: portal vein thrombosis.