A case of pyogenic liver abscess in a 10-year-old girl

Area of Science:

• Pediatric Infectious Diseases
• Hepatology
• Medical Imaging

Background:

• Pyogenic liver abscesses (PLAs) are rare in pediatric populations.
• While altered host defenses are often implicated, PLAs can also affect healthy children.
• This case focuses on a PLA in an immunocompetent child, highlighting atypical presentations.

Purpose of the Study:

• To report a case of pyogenic liver abscess in a healthy, immunocompetent child.
• To describe the management of multiple, distinct abscesses (subphrenic and intrahepatic).
• To review the literature on pediatric pyogenic liver abscesses.

Main Methods:

• Case presentation of a 10-year-old girl with pyogenic liver abscess.
• Treatment involved percutaneous drainage for the intrahepatic abscess.
• Management of the subphrenic abscess included prolonged parenteral and oral antibiotics.
• Serial CT scans were utilized for monitoring abscess resolution and guiding antibiotic duration.

Main Results:

• The intrahepatic abscess resolved with percutaneous drainage and 3 weeks of antibiotics.
• The subphrenic abscess, which was not amenable to drainage, required extended antibiotic therapy.
• Complete resolution was achieved with the combined therapeutic approach.

Conclusions:

• Pyogenic liver abscess can occur in healthy, immunocompetent children.
• Management requires a tailored approach, potentially involving both drainage and prolonged antibiotic courses.
• Serial imaging is crucial for monitoring treatment response and determining antibiotic duration.