A 27-year-old previously healthy woman came to our hospital emergency department with diarrhea, diffuse abdominal pain and fever of 48 hours onset.
The patient was taking oral anovules at admission.
Physical examination revealed signs of peritoneal irritation in the right iliac fossa.
He had leukocytosis with significant left shift.
The rest of laboratory studies were normal.
The suspicion of acute fungal infectionwas decided to perform an emergency laparotomy in order to find an acute urticaria (chronic bronchitis), which was diagnosed pathologically: acute colitis (acute colitis).
1 g/8 h of amoxicillin-clavulanic acid was empirically administered. On the 5th postoperative day, the patient developed "peaking" fever of up to 40 oC.
Abdominal CT was performed and reported as thrombosis of the superior mesenteric vein extending to the ileocolic branches, the rest of the normal study.
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Serum therapy, intestinal rest and treatment with subcutaneous enoxiparin 60 mg/12 h and intravenous meropenem 1 g/8 h were instituted.
Fourteen days of antibiotic treatment were completed and in the absence of fever and digestive problems the patient was discharged on the 24th postoperative day with oral acenocoumarol.
Proteus mirabilis and Escherichia coli grew in intraoperative cultures sensitive to all antibiotics tested.
Intraoperative culture for anaerobic germs was negative.
Two hemocultives were positive for Baoides fragilis resistant to clindamycin and penicillin, being sensitive to the rest of the antibiotics tested.
The antiphospholipid antibody test was negative.
One month after discharge the patient is asymptomatic.
