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Pyogenic liver abscess caused by Gemella morbillorum
Paolo Borro1, Alessandro Sumberaz1, Gianni Testino1
1IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy.
Abstract:
Even though Gemella morbillorum infection (GMI) is rare in humans, it may nevertheless, cause endocarditis, meningitis, brain abscess, pleural empyema, nephritis, mediastinitis, and--occasionally--liver abscess. We are describing the case of a 64-years-old Caucasian male admitted with fever and abdominal pain. Laboratory parameters revealed inflammation signs, and instrumental examinations showed the presence of diverticula in the ascending colon. Abdominal ultrasound (US) and computer tomography (CT) showed two focal lesions in the right liver lobe. One had the characteristics of a simple cyst; the second was hypoechoic with a low density area, possibly containing necrotic material. US-guided needle biopsy was found negative for neoplastic cells, showing purulent infiltrate. Pus culture was found positive for GMI. Systemic antibiotic therapy coupled with repeated US-guided needle aspiration, induced the resolution of the hepatic abscess. Few cases have been reported of hepatic abscess caused by GMI in immunocompetent non-cirrhotic subjects.
Insights
Gemella morbillorum infection (GMI) can cause rare liver abscesses in immunocompetent individuals. This case highlights successful treatment with antibiotics and aspiration for a hepatic abscess caused by GMI.
Area of Science:
- Microbiology
- Infectious Diseases
- Hepatology
Background:
- Gemella morbillorum infection (GMI) is a rare bacterial infection.
- While GMI can lead to severe conditions like endocarditis and meningitis, hepatic abscess is an infrequent manifestation.
- This report focuses on a case of liver abscess in an immunocompetent, non-cirrhotic patient.
Observation:
- A 64-year-old male presented with fever and abdominal pain.
- Imaging revealed colonic diverticula and two focal lesions in the right liver lobe.
- One lesion was cystic; the other was hypoechoic with a low-density area suggestive of necrosis.
Findings:
- US-guided biopsy showed purulent infiltrate, and pus culture confirmed Gemella morbillorum infection.
- The patient was treated with systemic antibiotics and repeated US-guided needle aspiration.
- Treatment led to the resolution of the hepatic abscess.
Implications:
- This case underscores the importance of considering GMI in the differential diagnosis of liver abscesses, even in immunocompetent individuals.
- Early diagnosis and appropriate management, including antibiotics and drainage, are crucial for favorable outcomes.
- Further research into the pathogenesis and optimal treatment strategies for GMI-induced hepatic abscesses is warranted.
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