Septic pelvic thrombophlebitis of unknown origin: an ever threatening entity

Autopsy And Case Reports

Endereço:
Av. Prof. Lineu Prestes, 2565
São Paulo / SP
05508-000
Site: http://www.autopsyandcasereports.org
Telefone: (11) 3091-9448
ISSN: 22361960
Editor Chefe: Maria Claudia Nogueira Zerbini
Início Publicação: 28/02/2011
Periodicidade: Trimestral
Área de Estudo: Medicina

Septic pelvic thrombophlebitis of unknown origin: an ever threatening entity

Ano: 2014 | Volume: 4 | Número: 3
Autores: R. M. L. Roepke, F. P. F. Campos, S. M. Lovisolo, E. H. S. Santos
Autor Correspondente: F. P. F. Campos | [email protected]

Palavras-chave: pelvis, thrombophlebitis, infection, venous thrombosis, abdominal pain

Resumos Cadastrados

Resumo Inglês:

Septic pelvic thrombophlebitis (SPT) is a rare and severe entity, which may occur after abortion, delivery, gynecological diseases, or surgeries. Diagnosis is challenging when no risk factor is clearly present, since clinically, symptoms are nonspecific. Nowadays, with the aid of imaging methods, diagnosis has become more achievable, but the treatment still bears some uncertainties. The authors present a fatal case of SPT in a young woman who sought medical care already presenting signs of septic shock, referring fever and non-characteristic abdominal pain. The patient evolved rapidly to multiple organ failure and respiratory distress, which was also due to septic pulmonary embolism. The autopsy confirmed the computed tomographic findings of a right ovarian vein septic thrombophlebitis and multiple septic pulmonary embolization foci. The patient did not present any of the recognized risk factors; neither did she present signs of pelvic inflammatory disease on admission or at autopsy. However, an intrauterine device was present. The authors call attention to this entity in the differential diagnosis of a woman with fever and abdominal pain, as well as for an empiric broadspectrum antibiotic regimen in these cases.