Drenching Sweats for 8 Weeks

gram negative anaerobe

Portal-vein thrombosis due to #Bacteroides fragilis infection

DDx: Yersinia, salmonella & campylobacter associated w/ ileocolitis, periappendiceal inflam & appendicitis post acute infection. Although self-limited enterocolitis more by Y. enterocolitica than by Y. pseudotuberculosis, latter more w/ mesenteric lymphadenitis & terminal ileitis

CT shows pylephlebitis(septic thrombophlebitis of portal veins): developed post appendicitis and periappendicitis, which were probably due to one of diarrheal pathogens. Pylephebiltis unusual by yersinia, salmonella, campy

Bacteroides species are components of the normal ileal and cecal flora. In appendicitis, both vascular flow to appendix & vascular leakage of bacteria are increased. Bacteroides & Ecoli possible

Thrombophlebitis possible in 5-12% of anaerobic bacteremia. B. fragilis expresses capsular polysaccharides that make it fibrinogenic. The unique immunologic properties found in the capsular zwitterionic polysaccharides of B. fragilis promotes procoagulant activity

Pylephlebitis begins w/ thrombophlebitis of small veins draining infected site. The involvement of larger veins leads to septic thrombophlebitis of portal vein extension to large mesenteric veins may cause bowel ischemia (rare) Embolization of infected thrombus ➡️liver abscesses

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360536/