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[Streptococcal abscesses of the liver: diagnosis and therapy using ultrasound controlled puncture]
W Schmüdderich1, J Weber, B Kohler
1Medizinische Klinik C, Klinikum der Stadt Ludwigshafen am Rhein.
Abstract:
Three male patients without accompanying diseases, 27, 47, and 52 years of age, were admitted with fever of unknown origin. Focal liver disease was seen on ultrasound and the diagnosis of an abscess was confirmed by sonographically-guided fine-needle puncture. Microaerophilic streptococci were found in two cases, streptococcus viridans once. Two patients had cryptogenic abscesses; one had previously undergone surgery for a rectal abscess. All three patients were cured of their condition by appropriate antibiotic coverage and evacuation of the abscess by needle aspiration.
Insights
This study reports on three male patients diagnosed with liver abscesses caused by streptococci. Prompt antibiotic treatment and needle aspiration successfully cured all patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Liver abscesses are serious infections requiring prompt diagnosis and treatment.
- Fever of unknown origin can be an initial symptom of intra-abdominal infections like liver abscesses.
Observation:
- Three male patients (27, 47, 52 years old) presented with fever of unknown origin.
- Ultrasound revealed focal liver disease, confirmed as abscesses via sonographically-guided fine-needle aspiration.
- Microaerophilic streptococci and Streptococcus viridans were identified as causative agents.
Findings:
- Two cases were cryptogenic liver abscesses, while one patient had a history of rectal abscess surgery.
- All patients received appropriate antibiotic therapy tailored to the identified streptococcal species.
- Successful treatment was achieved through a combination of antibiotics and needle aspiration for abscess evacuation.
Implications:
- This case series highlights the importance of considering liver abscesses in patients with unexplained fever.
- Sonographically-guided aspiration is crucial for diagnosis and therapeutic fluid removal.
- Effective management relies on accurate microbiological identification and targeted antibiotic therapy, leading to favorable patient outcomes.