Salam Reshad, Verma Abhiroop, Noeske Michael, Alnimer Lynna, Sieloff Eric M, Piper Marc S
Department of Internal Medicine, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI, USA.
Division of Radiology, Metrohealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Case Rep Gastroenterol. 2024 Mar 18;18(1):144-152. doi: 10.1159/000536619. eCollection 2024 Jan-Dec.
Pyogenic liver abscess is a noteworthy health concern in North America, characterized by a mortality rate ranging from 2 to 12%. This condition is often polymicrobial, with species and as the predominant causal pathogens in Western countries. species, typically commensals of gastrointestinal, genital, and oral flora, have been implicated in the rare formation of tonsillar abscesses and Lemierre syndrome, including its gastrointestinal variant known as pylephlebitis.
We present the case of an immunocompetent male with a 2-week history of abdominal distention and pain. Abdominal magnetic resonance imaging revealed multiseptated cystic hepatic masses and portal vein thrombosis. A subsequent liver biopsy confirmed etiology. The patient was initiated on intravenous cefepime and oral metronidazole antibiotics. Unfortunately, the patient succumbed to cardiac arrest before a final diagnosis could be established.
species-associated liver abscess, coupled with the rare gastrointestinal variant of Lemierre syndrome (pylephlebitis), poses a significant mortality risk. This case underscores the rarity and clinical challenges associated with these conditions. Increased awareness among clinicians is crucial for early diagnosis and prompt intervention, potentially improving outcomes in such cases.
化脓性肝脓肿在北美是一个值得关注的健康问题,死亡率在2%至12%之间。这种情况通常是多微生物感染,在西方国家,[具体菌种1]和[具体菌种2]是主要的致病病原体。[具体菌种]通常是胃肠道、生殖器和口腔菌群的共生菌,与罕见的扁桃体脓肿和勒米尔综合征的形成有关,包括其胃肠道变体即门静脉炎。
我们报告一例免疫功能正常的男性患者,有两周的腹胀和腹痛病史。腹部磁共振成像显示肝脏有多房囊性肿块和门静脉血栓形成。随后的肝脏活检证实了[具体病因]。患者开始接受静脉注射头孢吡肟和口服甲硝唑抗生素治疗。不幸的是,在最终诊断确立之前,患者因心脏骤停死亡。
[具体菌种]相关的肝脓肿,再加上罕见的勒米尔综合征胃肠道变体(门静脉炎),构成了重大的死亡风险。本病例强调了这些情况的罕见性和临床挑战。临床医生提高认识对于早期诊断和及时干预至关重要,可能改善此类病例的治疗结果。