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Tubercular liver abscess in immuno-competent patients
Balvir Singh1, Pritul D Saxena, Vinay Kumar
1P.G. Department of Medicine, S.N. Medical College, Agra.
The Journal of the Association of Physicians of India
|September 6, 2011
Summary
Two rare cases of liver abscesses caused by Mycobacterium tuberculosis were identified in patients unresponsive to standard treatments. Prompt diagnosis and anti-tubercular therapy led to significant clinical improvement, highlighting the importance of considering tuberculosis in refractory liver abscesses.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Liver abscesses are typically bacterial or amoebic in origin.
- Refractory cases necessitate a broader differential diagnosis.
Observation:
- Two patients, a 35-year-old male and a 15-year-old boy, presented with symptoms suggestive of liver abscess.
- Initial aspiration yielded sterile pus, and patients did not respond to antibiotics and amoebicides.
- Subsequent aspiration revealed Mycobacterium tuberculosis in both cases.
Findings:
- Mycobacterium tuberculosis was identified as the causative agent in both liver abscess cases.
- Anti-tubercular treatment resulted in dramatic clinical improvement in both patients.
Implications:
- Highlights the rarity and diagnostic challenge of tubercular liver abscesses.
- Emphasizes the need to suspect mycobacterial infection in non-responsive liver abscesses.
- Suggests considering tuberculosis in the differential diagnosis of liver abscesses, especially in endemic areas or in immunocompromised individuals.
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