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肝脏之外:微小消化链球菌穿透胸壁导致的化脓性肝脓肿罕见病例

Beyond the Liver: A Unique Case of Pyogenic Liver Abscess Caused by Peptostreptococcus micros Penetrating the Chest Wall.

作者信息

Isaac-Coss Giovannie, Chow Alex, Reddy Madhavi, Kumar Vikash, Nawaz Mohammad

机构信息

Internal Medicine, The Brooklyn Hospital Center, New York, USA.

Infectious Diseases, State University of New York (SUNY) Downstate Health Sciences University, New York, USA.

出版信息

Cureus. 2024 Jul 9;16(7):e64177. doi: 10.7759/cureus.64177. eCollection 2024 Jul.

Abstract

Liver abscesses are uncommon pyogenic infections with diverse microbiology, often involving enteric gram-negative bacilli such as and . Standard management includes antibiotic therapy and abscess drainage. We present a case of a 37-year-old male with chronic right upper quadrant abdominal pain, who was found to have an enlarging liver mass infiltrating the chest wall and right-side chest ribs, ultimately diagnosed as a large pyogenic liver abscess (PLA) extending into the chest wall. Notably, the abscess was attributed to , a rarely isolated pathogen in liver abscesses. Despite initial unsuccessful percutaneous drainage, surgical intervention proved necessary for definitive treatment. This case underscores the diagnostic challenge posed by uncommon pathogens in liver abscesses and emphasizes the effectiveness of surgical drainage in managing refractory cases.

摘要

肝脓肿是一种少见的化脓性感染,微生物学特征多样,常涉及肠道革兰氏阴性杆菌,如 和 。标准治疗包括抗生素治疗和脓肿引流。我们报告一例37岁男性,有慢性右上腹腹痛,发现肝脏肿物增大并侵犯胸壁和右侧胸肋,最终诊断为巨大化脓性肝脓肿(PLA)并延伸至胸壁。值得注意的是,该脓肿由 引起,这是一种在肝脓肿中很少分离出的病原体。尽管最初经皮引流未成功,但手术干预被证明是确定性治疗所必需的。该病例强调了肝脓肿中罕见病原体带来的诊断挑战,并强调了手术引流在处理难治性病例中的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e73/11309587/f8e02f155a95/cureus-0016-00000064177-i01.jpg

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