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Hepatic cyst infection in a healthy older male
Eiichiro Mori1, Yasuhiro Akai, Takaki Matsumoto
1Center for Postgraduate Training, Nara Medical University, Kashihara, Japan.
Abstract:
Simple hepatic cysts are usually asymptomatic and are not associated with impaired hepatic function. However, complications, such as obstructive jaundice, rupture, intracystic haemorrhage and infection, can occur. The authors describe the case of a 82-year-old man with fever and elevated C-reactive protein. A repeat contrast-enhanced abdominal CT scan revealed enlargement with peripheral enhancement in the left lateral segment of the liver. A diagnosis of infected hepatic cyst was made, and percutaneous transhepatic drainage of the cyst was performed. When a patient has liver cysts and high-grade fever, liver cysts should be considered as a focus of infection. Repetition of ultrasonography and/or CT studies should be considered, even if no typical findings are obtained initially. It is of note that conventional Ga-scintigraphy may be useful for the detection of infected site.
Insights
Infected hepatic cysts can cause fever and elevated inflammatory markers. Prompt imaging and drainage are crucial for diagnosis and treatment of these rare but serious liver complications.
Area of Science:
- Hepatology
- Infectious Diseases
- Radiology
Background:
- Simple hepatic cysts are typically benign and asymptomatic.
- Complications like infection, hemorrhage, and jaundice can occur.
- Infection in hepatic cysts presents a diagnostic challenge.
Observation:
- An 82-year-old male presented with fever and elevated C-reactive protein.
- Contrast-enhanced abdominal CT revealed an enlarged hepatic cyst with peripheral enhancement.
- The patient was diagnosed with an infected hepatic cyst.
Findings:
- Percutaneous transhepatic drainage was performed for the infected hepatic cyst.
- Elevated C-reactive protein and fever in patients with liver cysts suggest infection.
- Repeated imaging (ultrasonography/CT) may be necessary for diagnosis.
Implications:
- Infected hepatic cysts require prompt recognition and management.
- Consider hepatic cysts as a source of infection in febrile patients.
- Gallium-67 scintigraphy can aid in detecting infected sites.
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