Zuluaga-Gómez Mateo, Orjuela-Correa Robinson Andrés, González-Arroyave Daniel, Naranjo-Hernández Daniel, Ardila Carlos Martín
Medicine Department, San Vicente Fundación Hospital, Rionegro 054047, Colombia.
Simulation Laboratory, Bolivariana University, Medellín 050031, Colombia.
Med Int (Lond). 2023 Jan 3;3(1):5. doi: 10.3892/mi.2023.65. eCollection 2023 Jan-Feb.
A liver abscess is an entity that is rarely observed in the emergency department; therefore, it requires timely diagnosis by the clinicians who support this service. The early diagnosis of a liver abscess is challenging as variable and non-specific symptoms are present; furthermore, symptoms may differ in patients with human immunodeficiency virus (HIV) infection. To date, reports on the presentation of diagnostic ultrasound with point-of-care ultrasonography (PoCUS) are limited. The present case report study describes a patient diagnosed with HIV and the presence of a liver abscess confirmed by PoCUS performed in an emergency department. The patient presented with abdominal pain upon palpation in the right hypochondrium and in the thoracoabdominal area, which became more severe with inspiration. PoCUS revealed a hypodense intrahepatic image observed between segments VII and VI, with internal echoes suggestive of a liver abscess. Moreover, it was decided to perform tomography-guided percutaneous drainage of the liver abscess. Antibiotic treatment with ampicillin/sulbactam and IV metronidazole was also commenced. The patient presented clinical improvement and was discharged on the third day.
肝脓肿是一种在急诊科很少见到的病症；因此，需要为该科室提供支持的临床医生及时进行诊断。肝脓肿的早期诊断具有挑战性，因为其症状多样且不具有特异性；此外，人类免疫缺陷病毒（HIV）感染患者的症状可能有所不同。迄今为止，关于床旁超声检查（PoCUS）在诊断肝脓肿方面表现的报道有限。本病例报告研究描述了一名被诊断为HIV感染且在急诊科通过PoCUS确诊存在肝脓肿的患者。该患者在右季肋部及胸腹区域触诊时出现腹痛，吸气时疼痛加剧。PoCUS显示在肝段VII和VI之间观察到一个肝内低密度图像，内部回声提示为肝脓肿。此外，决定对肝脓肿进行断层扫描引导下的经皮引流。同时开始使用氨苄西林/舒巴坦和静脉注射甲硝唑进行抗生素治疗。患者临床症状有所改善，并于第三天出院。
