Emergency Department and Department of Infectious Diseases, Huashan Hospital of Fudan University, Shanghai, 200040, China.
Department of Infectious Diseases, Huashan Hospital of Fudan University, Shanghai, China.
BMC Neurol. 2022 Jul 30;22(1):286. doi: 10.1186/s12883-022-02806-y.
Liver abscess is a common emergency in the emergency department. However, cerebral venous sinus thrombosis (CVST) is a rare and serious cerebrovascular disease. Cases of CVST in patients with Klebsiella pneumoniae primary liver abscess (KLA) have not been described in the literature. We report a case of CVST in patients with KLA.
A 54-year-old male patient came to our department with a fever for 2 days and altered mental status for 1 day. Abdominal computed tomography (CT) and liver magnetic resonance imaging (MRI) revealed multiple liver abscesses. The blood culture was identified as Klebsiella pneumoniae sepsis. Head contrast-enhanced MRI and magnetic resonance venography (MRV) imaging showed multiple thrombus formation in the right transverse sinus and sigmoid sinus. The patient's infection and thrombosis were controlled within one week of multidisciplinary comprehensive treatment such as antibiotic and antithrombotic therapy, and a good clinical recovery during the 1-month follow-up.
CVST after liver abscess is rare, clinicians should be aware of this complication and vigilant for the possibility of bacterial meningitis. The underlying mechanisms need to be further studied.
肝脓肿是急诊科常见的急症。然而，脑静脉窦血栓形成（CVST）是一种罕见且严重的脑血管疾病。文献中尚未描述肺炎克雷伯菌原发性肝脓肿（KLA）患者并发 CVST 的情况。我们报告了一例 KLA 合并 CVST 的病例。
一名 54 岁男性患者因发热 2 天伴精神状态改变 1 天来我院就诊。腹部 CT 和肝脏 MRI 显示多发肝脓肿。血培养鉴定为肺炎克雷伯菌败血症。头部增强 MRI 和磁共振静脉造影（MRV）成像显示右侧横窦和乙状窦多发血栓形成。经过多学科综合治疗（如抗生素和抗血栓治疗）一周后，患者的感染和血栓得到控制，在 1 个月的随访期间临床恢复良好。
肝脓肿后发生 CVST 较为罕见，临床医生应意识到这种并发症的存在，并警惕细菌性脑膜炎的可能性。其潜在机制需要进一步研究。
