Gonçalves Rita João, Murinello António, Gomes da Silva Sílvia, Coelho João Santos, Lopes Santos Adriana, Sá Damásio Helena
Infectious Diseases Department, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Internal Medicine Department, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
GE Port J Gastroenterol. 2019 Oct;26(6):414-419. doi: 10.1159/000497333. Epub 2019 Mar 29.
Foreign-body ingestion is a common event, but in only less than 1% of the cases complications occur. Hepatic abscesses induced by foreign-body penetration are rare. To date, there are only 62 reported cases of hepatic abscess secondary to fish bone perforation of the gastrointestinal tract.
A 78-year-old male patient was admitted due to high fever and vomiting for 2 days, along with frequent eructations for the past 3 months. Abdominal ultrasound showed a liver abscess in the left lobe, and computed tomography revealed a hyperdense linear image that crossed the superior wall of the gastric antrum, contacting the liver lesion, suggestive of a foreign body, probably a fish bone. Blood cultures were positive with isolation of and Ultrasound-guided percutaneous drainage of the abscess was done, and was isolated in the pus. Surgical debridement and fish bone removal were performed; the patient completed 21 days of antibiotic therapy, with a favorable evolution.
To the best of our knowledge, this is the first reported case of liver abscess caused by fish bone penetration with isolation of and Bacterial coaggregation is one of the mechanisms that can explain their ability for causing invasive infections away from the oral cavity, by increasing their resistance to the innate immune system and survival of both species.
异物摄入是一种常见情况，但仅有不到1%的病例会出现并发症。异物穿透导致的肝脓肿较为罕见。迄今为止，仅有62例胃肠道鱼刺穿孔继发肝脓肿的报道病例。
一名78岁男性患者因高热、呕吐2天入院，过去3个月频繁呃逆。腹部超声显示左叶肝脓肿，计算机断层扫描显示一条高密度线性影像穿过胃窦上壁，与肝脏病变相连，提示有异物，可能是鱼刺。血培养阳性，分离出[具体细菌名称1]和[具体细菌名称2]。在超声引导下对脓肿进行经皮引流，脓液中分离出[具体细菌名称3]。进行了手术清创和取出鱼刺；患者完成了21天的抗生素治疗，病情好转。
据我们所知，这是首例报道的因鱼刺穿透导致肝脓肿并分离出[具体细菌名称1]和[具体细菌名称2]的病例。细菌共聚是一种机制，可解释它们通过增强对先天免疫系统的抵抗力以及两种细菌的存活能力，从而导致在口腔外引发侵袭性感染的能力。
