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Volume 15
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10.3390/life15101525
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Pylephlebitis: A Rare but Redoubtable Complication of Intra-Abdominal Infections—A Series of 15 Cases

by
Serban Nicolae Benea
1,2,†,
Teodora Deaconu
1,2,†,
Dragos Florea
1,2,*,
Ruxandra Moroti
1,2,*,
Gabriela Oprica
1,2,
Alina Nae
1,2,
Raluca Elena Patrascu
1,2,
Eliza Militaru
1,2,
Habip Gedik
3 and
Ilinca Savulescu-Fiedler
1,4
1
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
2
National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, 021105 Bucharest, Romania
3
Department of Infectious Diseases and Clinical Microbiology, Hamidiye School of Medicine, University of Health Sciences Istanbul, 34668 Istanbul, Turkey
4
Department of Internal Medicine, Coltea Clinical Hospital, 030167 Bucharest, Romania
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Life 2025, 15(10), 1525; https://doi.org/10.3390/life15101525 (registering DOI)
Submission received: 26 August 2025 / Revised: 21 September 2025 / Accepted: 25 September 2025 / Published: 26 September 2025
(This article belongs to the Special Issue Diagnosis and Management of Microbial Infections)
Versions Notes

Abstract

Pylephlebitis is the suppurative thrombosis of the portal vein system. Mainly reported as a severe complication of diverticulitis or appendicitis, it is an uncommon intra-abdominal infection: approximately 200 cases have been reported in the English literature, mostly from surgical wards. Our study aims to assess the role of an infectious disease setting in managing pylephlebitis. We reviewed medical records from 2001 to 2024 at a tertiary infectious diseases hospital and identified 15 cases. The median age was 58 years [IQR = 28], with a male-to-female ratio of 4:1. Along with portal vein thrombosis (PVT), liver abscess(es) was/were the main radiological finding (n = 12), representing 80% of cases. The liver abscesses appear as secondary events in the case of pylephlebitis. In seven of 15 cases, we found the primary event associated with pylephlebitis. Blood cultures were positive in eight cases, with Gram-negative aerobic bacteria being commonly isolated (n = 5), followed by anaerobes (n = 3); in half of the cases, more than one pathogen was involved. All patients received broad-spectrum antibiotics containing beta-lactams, including eight who received carbapenems. Anticoagulation therapy was used in 14 cases. Two deaths were recorded, and four patients required surgical intervention, highlighting the importance of prompt diagnosis and swift antibiotic and anticoagulant treatment.
Keywords: pylephlebitis; suppurative portal vein thrombosis; liver abscess; intra-abdominal infection complications; sepsis pylephlebitis; suppurative portal vein thrombosis; liver abscess; intra-abdominal infection complications; sepsis

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MDPI and ACS Style

Benea, S.N.; Deaconu, T.; Florea, D.; Moroti, R.; Oprica, G.; Nae, A.; Patrascu, R.E.; Militaru, E.; Gedik, H.; Savulescu-Fiedler, I. Pylephlebitis: A Rare but Redoubtable Complication of Intra-Abdominal Infections—A Series of 15 Cases. Life 2025, 15, 1525. https://doi.org/10.3390/life15101525

AMA Style

Benea SN, Deaconu T, Florea D, Moroti R, Oprica G, Nae A, Patrascu RE, Militaru E, Gedik H, Savulescu-Fiedler I. Pylephlebitis: A Rare but Redoubtable Complication of Intra-Abdominal Infections—A Series of 15 Cases. Life. 2025; 15(10):1525. https://doi.org/10.3390/life15101525

Chicago/Turabian Style

Benea, Serban Nicolae, Teodora Deaconu, Dragos Florea, Ruxandra Moroti, Gabriela Oprica, Alina Nae, Raluca Elena Patrascu, Eliza Militaru, Habip Gedik, and Ilinca Savulescu-Fiedler. 2025. "Pylephlebitis: A Rare but Redoubtable Complication of Intra-Abdominal Infections—A Series of 15 Cases" Life 15, no. 10: 1525. https://doi.org/10.3390/life15101525

APA Style

Benea, S. N., Deaconu, T., Florea, D., Moroti, R., Oprica, G., Nae, A., Patrascu, R. E., Militaru, E., Gedik, H., & Savulescu-Fiedler, I. (2025). Pylephlebitis: A Rare but Redoubtable Complication of Intra-Abdominal Infections—A Series of 15 Cases. Life, 15(10), 1525. https://doi.org/10.3390/life15101525

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