Hysterectomy, bilateral salpingo-oophorectomy, and removal of a portion of the inferior vena cava were required in a case of septic ovarian vein thrombophlebitis unresponsive to antibiotic and anticoagulant therapy. Persistent microaerophilic streptococcal sepsis responded to penicillin and streptomycin only after the ovarian vein abscess and adjacent infected pelvic tissues were removed. Anaerobic cultures were of paramount importance in isolation and identification of the causal microorganism. While partial vena cavectomy represents radical surgical management, it was accompanied by no serious sequelae and was lifesaving. The extent of operation for ovarian vein thrombophlebitis should be individualized.
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