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[An elderly case of giant infected liver cyst that decreased dramatically without percutaneous aspiration]
1Division of Geriatric Medicine, Nippon Medical School.
Insights
A 70-year-old woman with an infected liver cyst was successfully treated with antibiotics alone. The large cyst significantly reduced in size, resolving symptoms and avoiding invasive procedures.
Area of Science:
- Hepatology
- Infectious Diseases
- Medical Imaging
Background:
- A 70-year-old female presented with cholelithiasis and a history of a giant liver cyst.
- The patient exhibited symptoms of infection, including low-grade fever and hepatomegaly.
Observation:
- Laboratory results revealed elevated white blood cell count, C-reactive protein, and liver enzymes (GPT, ALP, gamma-GTP, LAP).
- Contrast-enhanced CT scan confirmed an 8 cm infected liver cyst with no communication to the intrahepatic bile duct.
Findings:
- The infected liver cyst was successfully managed non-surgically with intravenous antibiotics.
- Follow-up CT scan at 4 months showed a dramatic reduction in cyst size to 1 cm.
Implications:
- This case highlights the potential efficacy of antibiotic therapy as a primary treatment for infected liver cysts.
- Conservative management may obviate the need for invasive procedures like percutaneous aspiration or surgery in select cases.
Abstract:
A 70-year-old woman was referred to our hospital for treatment of cholelithiasis. A giant liver cyst (6 cm in diameter) had been diagnosed three years earlier. On admission, she had low grade fever and hepatomegaly. High values were observed for WBC (9900/microliter), CRP (8.9 mg/dl), GPT (45 IU/l), ALP (1399 IU/l), gamma-GTP (333 IU/l) and LAP (249 IU/l). The diagnosis of infected liver cyst (8 cm in diameter) was made based on contrast-enhanced CT scan. Endoscopic retrograde cholangiopancreaticography showed no communication between the cyst and the intrahepatic bile duct. She was successfully managed with antibiotics and discharged without percutaneous aspiration the cyst. On abdominal CT scan 4 months after the discharge, the liver cyst had decreased dramatically in size (1 cm in diameter). The patient remains healthy without symptoms.
