Pylephlebitis as a Complication of Cholangitis and Sepsis in an HIV-Positive Patient

Excerpt

Pylephlebitis, a thrombophlebitis of the portal venous tree following bacterial sepsis, is a serious condition with detrimental effects on liver function and possible lethal consequences. Extrahepatic inflammatory conditions, such as sepsis, are considered to be the main risk factors for portal vein clot in noncirrhotics [1]. In clinical practice, doubts regarding the best management of these patients persist, especially regarding the type of anticoagulant to use, when to start it, and the optimal dosage [2]. We discuss herein a case of pylephlebitis in a patient under treatment with antiprotease for human immunodeficiency virus (HIV) infection to cure a biliary tract infection and sepsis from Escherichia coli, complicated by pneumonia, that benefited from antibiotics, but only partially from anticoagulant treatment. …