PDF(Pubmed)
Abstract：
Portal vein thrombophlebitis is a rare complication that can occur in various hypercoagulable states, including COVID-19. We are presenting a 74-year-old female with a history of hypertension, diabetes, and lymphoma who contracted the COVID-19 infection and presented with persistent fever, leukocytosis, and mild epigastric tenderness. She developed hypotension, acute hypoxic respiratory failure, and worsening leukocytosis with bandemia and was diagnosed with portal vein thrombosis (PVT) and superior mesenteric vein thrombosis. The patient received broad-spectrum IV antibiotics and full anticoagulation therapy with heparin and was discharged on oral Warfarin after completing 14-day antibiotic therapy. She presented again with recurrent watery diarrhea, fever, abdominal pain, and fatigue and was diagnosed with pylephlebitis and multiple small liver abscesses. The patient was treated with antibiotics for six weeks and was discharged on warfarin, furosemide, and spironolactone with close outpatient follow-up. Prolonged fever in COVID-19 patients can indicate extensive thrombosis at unusual sites, which can lead to major morbidity and mortality in patients.
摘要：
门静脉血栓性静脉炎是一种罕见的并发症，可发生在各种高凝状态，包括COVID-19。我们介绍了一位74岁的女性，有高血压病史，糖尿病,和感染COVID-19感染并持续发烧的淋巴瘤，白细胞增多,和轻度上腹压痛.她出现了低血压,急性低氧性呼吸衰竭,白细胞增多伴绷带症恶化，并被诊断为门静脉血栓形成（PVT）和肠系膜上静脉血栓形成。患者接受广谱IV抗生素和肝素全面抗凝治疗，并在完成14天抗生素治疗后口服华法林出院。她又出现了经常性的水样腹泻，发烧,腹痛,和疲劳，被诊断为静脉炎和多发性小肝脓肿。病人接受抗生素治疗六周后服用华法林出院,呋塞米,和螺内酯密切门诊随访。COVID-19患者的长期发烧可能表明异常部位广泛血栓形成，这可能导致患者的严重发病率和死亡率。
