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Pyogenic liver abscess: uncommon presentation.

Joana Sotto Mayor1, Maria Margarida Robalo2, Ana Paula Pacheco1

  • 1Department of Internal Medicine, Hospital de Braga, Braga, Portugal.

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Summary

Pyogenic liver abscess, though rare, can be fatal if untreated. Early diagnosis and intervention, aided by modern techniques, are crucial for patient outcomes.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Pyogenic liver abscess (PLA) is a rare but potentially fatal condition, typically affecting individuals in their fifth decade.
  • Prompt recognition and intervention are vital for successful treatment and improved patient prognosis.
  • Advances in percutaneous drainage, imaging, and microbiology have refined PLA management, optimizing antibiotic therapy.

Observation:

  • Clinical presentations of PLA are diverse, influenced by abscess size, patient health, comorbidities, and complications.
  • Common symptoms include upper abdominal pain, high fever, nausea, and vomiting.
  • This case highlights an unusual initial presentation of atrial flutter preceding a hepatic abscess that mimicked a liver tumor on imaging.

Findings:

  • The study emphasizes the variable clinical manifestations of pyogenic liver abscess.
  • It underscores the importance of considering PLA even with atypical initial symptoms like atrial flutter.
  • The case illustrates how hepatic abscess can present with imaging findings suggestive of a hepatic tumor.

Implications:

  • This case broadens the differential diagnosis for atrial flutter, suggesting hepatic abscess as a potential cause.
  • It reinforces the need for comprehensive diagnostic workups when faced with atypical presentations of common conditions.
  • Improved awareness of rare presentations can lead to earlier diagnosis and treatment of pyogenic liver abscess, improving patient outcomes.