Brucella Causing Liver Abscess in a Child with Selective IgA Deficiency.

Area of Science:

• Infectious Diseases
• Pediatric Medicine
• Hepatology

Background:

• Brucella species are known pathogens causing pyrexia of unknown origin.
• Liver abscesses can manifest as a complication of Brucella infection.

Observation:

• A 9-year-old boy presented with fever and abdominal pain, revealing multiple liver abscesses on ultrasonography.
• Laboratory findings included positive IgM antibodies against Brucella and a positive Brucella serum agglutination test.
• Immunological work-up indicated a selective IgA deficiency.

Findings:

• The patient's liver abscesses showed a reduction in size after treatment with trimethoprim-sulfamethoxazole, amikacin, and doxycycline.
• Brucellosis was confirmed as the etiological agent responsible for the liver abscesses.

Implications:

• Brucellosis should be considered in the differential diagnosis of liver abscesses, particularly in cases unresponsive to standard antibiotic regimens.
• This case highlights the importance of considering zoonotic infections in pediatric hepatobiliary pathology.
• Management requires a combination of antibiotics targeting Brucella and addressing any underlying immune deficiencies.