Hepatic portal venous gas associated with Klebsiella oxytoca infection in the absence of preceding antibiotic treatment

  • Hidekazu Tanaka
  • Tomohiro WatanabeEmail author
  • Tomoyuki Nagai
  • Kosuke Minaga
  • Ken Kamata
  • Yoriaki Komeda
  • Masatoshi Kudo
Case Report


Klebsiella oxytoca (K. oxytoca) is a causative organism for hemorrhagic antibiotic-associated colitis. K. oxytoca infection is a typical example of microbial substitution diseases caused by exposure to antibiotics prior to the onset of diarrhea. Here, we repot a case with ileitis associated with K. oxytoca infection in the absence of preceding antibiotic treatment. Interestingly, abdominal computed tomography revealed wall thickening of the ileum and hepatic portal venous gas (HPVG). K. oxytoca was isolated from the stool. This very elderly patient had been treated with azathioprine for long-standing history of ulcerative colitis. Immuno-compromised state of this patient was considered to allow overgrowth of K. oxytoca in the small bowel to cause not only ileitis but also HPVG.


Hepatic portal venous gas Antibiotics Klebsiella oxytoca 


Compliance with ethical standards

Conflict of interest

Hidekazu Tanaka, Tomohiro Watanabe, Tomoyuki Nagai, Kosuke Minaga, Ken Kamata, Yoriaki Komeda, and Masatoshi Kudo declare that they have no conflict of interest in the subject matter or materials discussed in the manuscript.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  • Hidekazu Tanaka
    • 1
  • Tomohiro Watanabe
    • 1
    Email author
  • Tomoyuki Nagai
    • 1
  • Kosuke Minaga
    • 1
  • Ken Kamata
    • 1
  • Yoriaki Komeda
    • 1
  • Masatoshi Kudo
    • 1
  1. 1.Department of Gastroenterology and HepatologyKindai University Faculty of MedicineOsaka-SayamaJapan

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