Hachem Jack, Christodoulou Anthoula, Hunt William, Manaloor John, Monagas Javier J
Pediatric Gastroenterology, Baylor College of Medicine, San Antonio, USA.
Pediatrics, Baylor College of Medicine, San Antonio, USA.
Cureus. 2025 Jun 10;17(6):e85741. doi: 10.7759/cureus.85741. eCollection 2025 Jun.
This case report describes a rare occurrence of a hepatic abscess in a five-year-old girl following esophageal interventions due to caustic ingestion. Persistent strictures led to multiple balloon dilations and serial esophageal stents, after which she developed abdominal pain, fever, and anorexia. Imaging revealed a complex hepatic abscess. Cultures identified and , organisms typically found in the oral cavity, suggesting bacterial translocation due to mucosal disruption from the esophageal procedures. The patient initially received ceftriaxone and metronidazole, showing improvement, but experienced fever recurrence upon switching to ampicillin/sulbactam, necessitating a return to the original antibiotic regimen. The patient eventually recovered with continued treatment, highlighting the risk of serious infections following esophageal interventions in pediatric patients. This case underscores the importance of considering prophylactic antibiotics to prevent such complications, especially in high-risk pediatric patients undergoing repeated interventions. When infectious complications do occur, both antibiotic management and source control are necessary for definitive treatment. Further research is needed to establish guidelines for prophylactic measures in similar clinical scenarios.
本病例报告描述了一名五岁女孩在因腐蚀性物质摄入而进行食管干预后罕见地发生肝脓肿的情况。持续性狭窄导致多次球囊扩张和系列食管支架置入,之后她出现腹痛、发热和厌食。影像学检查显示为复杂性肝脓肿。培养物鉴定出 和 ,这些是口腔中常见的微生物,提示由于食管手术导致的黏膜破坏引起细菌移位。患者最初接受头孢曲松和甲硝唑治疗,病情有所改善,但换用氨苄西林/舒巴坦后出现发热复发,因此需要恢复原抗生素治疗方案。患者最终通过持续治疗康复,突出了儿科患者食管干预后发生严重感染的风险。本病例强调了考虑预防性使用抗生素以预防此类并发症的重要性,特别是在接受重复干预的高危儿科患者中。当发生感染性并发症时,抗生素管理和源头控制对于确定性治疗都是必要的。需要进一步研究以建立类似临床场景中预防措施的指南。