Singh Balvir, Saxena Pritul D, Kumar Vinay, Yadav Devendra, Rajpoot Preeti
P.G. Department of Medicine, S.N. Medical College, Agra.
J Assoc Physicians India. 2011 Aug;59:523-4.
We report two cases, the first one a 35 years old male, chronic alcoholic, and the other, a 15 years old boy, who presented to us with fever, Rt. hypochondrial pain, with USG-Abdomen revealing multiple liver abscesses in the first, and a single large abscess in the second. Both patients showed leucocytosis and, mildly deranged Liver Function Tests. Aspirated pus was sterile, and the patients did not show any clinical improvement despite broad spectrum antibiotics and amoebicides. Re-aspiration of pus after two weeks revealed the presence of Mycobacterium tuberculosis and both patients showed a dramatic improvement clinically after starting Anti-tubercular treatment. These cases are being reported because of the rarity of tubercular liver abscesses, and the importance of suspecting mycobacterial infection in patients of liver abscess not responding to conventional treatment.
我们报告两例病例，第一例是一名35岁的慢性酒精中毒男性，另一例是一名15岁男孩，他们因发热、右季肋部疼痛前来就诊。腹部超声检查显示，第一例患者有多个肝脓肿，第二例患者有一个大的肝脓肿。两名患者均出现白细胞增多，肝功能检查轻度异常。抽出的脓液无菌，尽管使用了广谱抗生素和抗阿米巴药物，患者的临床症状仍未改善。两周后再次抽脓发现存在结核分枝杆菌，两名患者开始抗结核治疗后临床症状显著改善。报告这些病例是因为结核性肝脓肿罕见，以及对于常规治疗无反应的肝脓肿患者怀疑分枝杆菌感染的重要性。
