Schmiedecke Stacey S, Napolitano Peter G, Estrada Sarah M
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Madigan Army Medical Center, Tacoma, Washington.
AJP Rep. 2019 Jul;9(3):e251-e255. doi: 10.1055/s-0039-1692713. Epub 2019 Aug 20.
Pyogenic liver abscess (PLA) is a rare clinical entity, occurring in ∼2.3 per 100,000 patients. Perinatal PLA syndromes are exceedingly rare with just seven previously described cases in the literature and no prior Klebsiella-associated reports. A 29-year-old gravida 2 para 1 woman at 11 weeks gestation reporting fever, body aches, and headache. Search for an infectious source identified a 4-cm liver abscess. Percutaneous drainage confirmed infection. The patient was treated with antibiotics until imaging verified complete resolution of the abscess. PLA is an uncommon etiology of sepsis in pregnancy. A thorough workup until a source was identified resulted in accurate diagnosis. This allowed for directed therapy and prompt recovery, undoubtedly contributing to favorable pregnancy outcomes in this first report of Klebsiella-associated perinatal PLA.
化脓性肝脓肿(PLA)是一种罕见的临床病症,每10万名患者中约有2.3人发病。围产期PLA综合征极为罕见,文献中此前仅描述过7例,且无先前与克雷伯菌相关的报道。一名29岁、孕2产1的女性,妊娠11周,出现发热、身体疼痛和头痛症状。寻找感染源时发现一个4厘米的肝脓肿。经皮引流证实存在感染。患者接受抗生素治疗,直至影像学检查证实脓肿完全消退。PLA是妊娠期脓毒症的一种罕见病因。经过全面检查直至确定病因后才得以准确诊断。这使得能够进行针对性治疗并迅速康复,无疑有助于在这份首例与克雷伯菌相关的围产期PLA报告中取得良好的妊娠结局。