An unusual case of pylephlebitis without a primary site of infection

Pylephlebitis describes septic thrombosis of the portal vein. The most common risk factor for this condition is intra-abdominal infection. Nevertheless, the underlying cause remains unidentified in >10% of cases. Although uncommon, pylephlebitis should be considered in patients with septic shock, especially when no primary site of infection is identified. In addition to early antibiotic therapy, treatment considerations include anticoagulation. Early recognition of this entity may improve the course of the disease.