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Lemierre’s syndrome variant of the gut
  1. Thomas E. Mellor1,
  2. Natalie Mitchell1,
  3. Jessica Logan2
  1. 1Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  2. 2Department of Internal Medicine, Washington DC VA Medical Center, Washington, D.C., USA
  1. Correspondence to Dr Thomas E. Mellor, tmellor1{at}


Infectious suppurative thrombophlebitis of the portal venous system, referred to as pylephlebitis, is a rare complication of intra-abdominal inflammatory processes. Advances in diagnostics and antibiotics have improved survival, but mortality remains remarkably high even in the most recent literature. The majority of patients have concomitant bacteraemia on presentation most commonly with typical gastrointestinal (GI) organisms. On rare occasion, patients have culture positive Fusobacterium, which has recently been associated with occult GI and genitourinary malignancies. Here, we describe a patient presenting with pylephlebitis and Fusobacterium bacteraemia who responded well to medical therapy, review pertinent literature and discuss the benefits of screening endoscopy in this patient population.

  • infectious diseases
  • infection (gastroenterology)
  • haematology (incl blood transfusion)

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  • Contributors All three authors contributed equally to letter concept. TEM and NM wrote the manuscript, and JL provided critical review. TEM is the article guarantor.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.