Sng Edwin Chong Yu, Chavatte Jean-Marc
Department of Infectious Diseases, Changi General Hospital, Singapore, Singapore.
National Public Health Laboratory, National Centre for Infectious Diseases, Ministry of Health, Singapore, Singapore.
Case Rep Infect Dis. 2025 Mar 20;2025:6230349. doi: 10.1155/crdi/6230349. eCollection 2025.
A liver abscess can be due to several different microbiological aetiologies. While pyogenic liver abscess is most frequently encountered, amoebic liver abscess and hydatid cyst caused by the parasites, and respectively, should be considered whenever there is epidemiological exposure. As parasitic infections are now rarely seen in clinical practice in developed countries with improvement in sanitation, lack of clinical experience in managing amoebic liver abscesses and overlapping clinical and imaging features between amoebic and pyogenic liver abscesses may lead to delay in diagnosis. In particular, although amoebic liver abscesses respond well to treatment if diagnosed early, they can progress and rupture with high mortality if treatment is delayed. Hence, early diagnosis and prompt initiation of antimicrobials are crucial to prevent complications and death. This case report highlights a case of a very large 21 cm ALA in a young lady to illustrate the challenges faced during diagnostic evaluation.
肝脓肿可能由几种不同的微生物病因引起。虽然化脓性肝脓肿最为常见,但只要有流行病学暴露史,就应考虑由寄生虫引起的阿米巴肝脓肿和包虫囊肿。随着发达国家卫生条件的改善,寄生虫感染在临床实践中已很少见,缺乏管理阿米巴肝脓肿的临床经验以及阿米巴肝脓肿和化脓性肝脓肿之间重叠的临床和影像学特征可能导致诊断延迟。特别是,虽然阿米巴肝脓肿如果早期诊断对治疗反应良好,但如果治疗延迟,它们可能进展并破裂,死亡率很高。因此,早期诊断和及时使用抗菌药物对于预防并发症和死亡至关重要。本病例报告重点介绍了一名年轻女性患有一个非常大的21厘米阿米巴肝脓肿的病例,以说明诊断评估过程中面临的挑战。