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Citrobacter koseri: an unusual cause of pyogenic liver abscess

Monica Gupta1, Alka Sharma, Ram Singh

  • 1Department of Medicine, Government Medical College and Hospital, Chandigarh, India. monicamanish2001@gmail.com

BMJ Case Reports
|March 19, 2013
PubMed

Insights

Pyogenic liver abscesses are common, but Citrobacter koseri is a rare cause. This case highlights a diabetic patient with a history of periampullary carcinoma who developed a Citrobacter koseri hepatic abscess.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Microbiology

Background:

  • Liver abscess is a frequent condition in the Indian subcontinent, typically caused by amoebic or bacterial pathogens.
  • Pyogenic liver abscesses often develop in patients with predisposing factors such as intra-abdominal infections, biliary issues, or comorbidities like diabetes mellitus and malignancy.

Observation:

  • This report details a 56-year-old male patient with a history of diabetes and prior surgery for periampullary carcinoma.
  • The patient presented with a week-long history of fever and was diagnosed with a liver abscess.

Findings:

  • The liver abscess was identified as being caused by the bacterium Citrobacter koseri, an uncommon etiology.
  • The patient's medical history included diabetes and a remote surgical intervention for periampullary carcinoma.

Implications:

  • This case underscores that Citrobacter koseri can be an unusual cause of pyogenic liver abscess, particularly in patients with underlying comorbidities.
  • Effective management involved parenteral antibiotics, repeated abscess aspiration, and pigtail drainage.

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