{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T21:53:40Z","timestamp":1784757220906,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Septic pelvic thrombophlebitis (SPT) is a rare condition that forms thrombosis in the pelvic veins, typically the ovarian veins, with subsequent infection and inflammation. We present a case of right ovarian vein thrombosis (ROVT), methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) bacteremia, and delayed onset of SPT symptoms, requiring tissue\u2010plasminogen activator. A 40\u2010year\u2010old woman, G3P2, at 38\u2009weeks' gestation, was admitted with a fever of 39\u00b0C. She had cervical insufficiency and had been often on bed rest. Blood culture revealed MRSA and computed tomography revealed a large ROVT. She received vancomycin and direct oral anticoagulant, and her fever resolved by day 3. On day 16, fever recurred with severe pain over the ROVT. Second computed tomography showed thickening of venous wall with enhancement around ROVT, consistent with SPT. Since pain and fever gradually exacerbated despite treatment with DOAC and antimicrobials, she was started on heparin and tissue plasminogen activator on days 23 and 25, respectively. Along with recanalization on the thrombosis by day 29, fever and abdominal pain resolved. We experienced a case of delayed onset SPT associated with MRSA bacteremia and a large ROVT. MRSA bacteremia might cause the originally existing ROVT to become an infection source, resulting in SPT with recurrent symptoms and long\u2010term treatment. Early and strict anticoagulation is crucial in cases with a large thrombosis and bacteremia, due to the high risk of progression to SPT. This case highlights the importance of recanalization for the treatment of SPT and usefulness of administration of tissue\u2010plasminogen activator for the massive thrombosis.<\/jats:p>","DOI":"10.1111\/jog.15991","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T05:14:49Z","timestamp":1716959689000},"page":"1408-1414","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Delayed onset septic pelvic thrombophlebitis treated by tissue\u2010plasminogen activator following initial treatment for massive right ovarian vein thrombosis and methicillin\u2010resistant <i>Staphylococcus aureus<\/i> bacteremia: A case report"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1352-3738","authenticated-orcid":false,"given":"Daisuke","family":"Miyamori","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine Hiroshima University Hospital  Hiroshima\u2010shi Hiroshima\u2010ken Japan"},{"name":"Department of Emergency Medicine JA Onomichi General Hospital  Onomichi Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norifumi","family":"Shigemoto","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Hiroshima University Hospital  Hiroshima\u2010shi Hiroshima\u2010ken Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunobu","family":"Une","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine JA Onomichi General Hospital  Onomichi Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Cardiology JA Onomichi General Hospital  Onomichi Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shina","family":"Harimoto","sequence":"additional","affiliation":[{"name":"Department of Gynecology Miyoshi Central Hospital  Miyoshi Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohisa","family":"Sakashita","sequence":"additional","affiliation":[{"name":"Department of Gynecology JA Onomichi General Hospital  Onomichi Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine Hiroshima University Hospital  Hiroshima\u2010shi Hiroshima\u2010ken 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