Chen L-W, Chang L-C, Shie S-S, Chien R-N
Liver Research Unit, Chang-Gung Memorial Hospital, Keelung, Taiwan.
Int J Clin Pract. 2006 Jan;60(1):104-7. doi: 10.1111/j.1368-5031.2005.00691.x.
Hepatic actinomycotic abscesses are rare and secondary to other intra-abdominal infections. History of intra-abdominal surgery is a principal contributing factor for the abscess formation. Patients with hepatic actinomycotic abscess may suffer from fever, malaise, abdominal pain and bodyweight loss. The clinical progress of actinomycotic abscess is more indolent than the usual course of other pyogenic abscess. It is sometimes diagnosed as malignancy. This report consists of two cases of hepatic actinomycotic abscess mimicking tumours. Laboratory data revealed elevated alkaline phosphatase and leucocytosis. The abdominal computed tomography scan showed multiloculated lesions with peripheral contrast enhancement appearance. Diagnosis confirmation was based on the typical histologic feature of sulfur granules with inflammatory process by echo-guided fine needle biopsy or surgical specimen. These two cases were resolved with extended courses of intravenous and oral penicillin treatment.
肝放线菌脓肿较为罕见,继发于其他腹腔内感染。腹腔手术史是脓肿形成的主要促成因素。肝放线菌脓肿患者可能会出现发热、不适、腹痛和体重减轻。放线菌脓肿的临床进展比其他化脓性脓肿的通常病程更为隐匿。它有时被诊断为恶性肿瘤。本报告包含两例疑似肿瘤的肝放线菌脓肿病例。实验室数据显示碱性磷酸酶升高和白细胞增多。腹部计算机断层扫描显示多房性病变,具有周边对比增强表现。通过超声引导下细针穿刺活检或手术标本,依据硫磺颗粒的典型组织学特征及炎症过程确诊。这两例患者经延长疗程的静脉和口服青霉素治疗后痊愈。