儿童阿米巴肝脓肿继发巨大脓胸。
Massive pleural empyema secondary to amoebic liver abscess in a child.
机构信息
Instituto Nacional de Salud del Niño-Breña, Lima.
Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima.
出版信息
Bol Med Hosp Infant Mex. 2023;80(4):265-268. doi: 10.24875/BMHIM.23000041.
BACKGROUND
Pleural empyema secondary to a ruptured amoebic liver abscess is a rare complication in the pediatric population.
CASE REPORT
We report the case of a 13-year-old male with right flank abdominal pain, productive cough with foul-smelling sputum, fever, and respiratory distress. Physical examination revealed breathlessness, decreased vesicular murmur in the right hemithorax, abdominal distension, hepatomegaly, and lower limb edema. Laboratory tests revealed mild anemia, leukocytosis without eosinophilia, elevated alkaline phosphatase, hypoalbuminemia, and positive immunoglobulin G antibodies against Entamoeba histolytica in pleural fluid. He required a chest tube and treatment with metronidazole. After 2 months of follow-up, the abscesses disappeared, and the empyema decreased.
CONCLUSIONS
Massive pleural empyema secondary to a ruptured liver abscess is a rare complication. The epidemiological link associated with the symptoms and serological tests can help in the diagnosis.
背景
儿童中，由肝阿米巴脓肿破裂引起的脓胸是一种罕见的并发症。
病例报告
我们报告了 1 例 13 岁男性病例，其有右侧肋腹疼痛、咳痰伴恶臭、发热和呼吸窘迫。体格检查显示呼吸困难，右侧胸腔呼吸音减弱，腹部膨隆，肝肿大和下肢水肿。实验室检查显示轻度贫血、白细胞增多但无嗜酸性粒细胞增多、碱性磷酸酶升高、低白蛋白血症，胸腔积液中存在针对溶组织内阿米巴的免疫球蛋白 G 抗体阳性。他需要进行胸腔引流管插入和甲硝唑治疗。经过 2 个月的随访，脓肿消失，脓胸减少。
结论
由肝脓肿破裂引起的大量脓胸是一种罕见的并发症。与症状和血清学检查相关的流行病学联系有助于诊断。
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