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Multiloculated Liver Abscess Caused by Fusobacterium: Role of Karius Testing in Diagnosis
Hammad Zafar1, Mamoon Ur Rashid1, Bayarmaa Mandzhieva1
1Internal Medicine, AdventHealth Orlando, Orlando, USA.
Abstract:
Pyogenic liver abscess can be a major diagnostic and therapeutic challenge despite advances in cutting edge technologies. A patient presented with fever, right upper quadrant pain and diarrhea. CT revealed multiple hypodensities in both lobes of liver. The largest lesion was in the left lobe of liver and was multiloculated with thick septations. The causative organism was identified to be Fusobacterium nucleatum by Karius testing. The patient was discharged on six weeks of ertapenem therapy, which resulted in complete resolution. This is the first case of liver abscess where Karius testing was used to identify microorganism. It also highlights that multiloculated and difficult to drain liver abscesses caused by highly sensitive organisms can potentially be treated by intravenous antibiotics alone in immunocompetent patients.
Insights
A rare case of pyogenic liver abscess caused by Fusobacterium nucleatum was successfully treated with ertenzapeem alone. Karius testing identified the microorganism, enabling targeted antibiotic therapy for complete resolution.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Pyogenic liver abscess (PLA) presents diagnostic and therapeutic challenges.
- Advances in technology have improved outcomes, but complex cases remain.
- Multiloculated abscesses often require invasive procedures.
Observation:
- A patient presented with fever, right upper quadrant pain, and diarrhea.
- CT scans revealed multiple liver lesions, including a large, multiloculated abscess in the left lobe.
- Karius testing identified *Fusobacterium nucleatum* as the causative pathogen.
Findings:
- This is the first reported case of a liver abscess diagnosed using Karius testing.
- The patient received six weeks of ertapenem therapy.
- Complete resolution of the liver abscess was achieved with intravenous antibiotics alone.
Implications:
- Karius testing offers a novel approach for identifying microorganisms in liver abscesses.
- Multiloculated liver abscesses caused by susceptible organisms may be treated non-surgically with antibiotics in immunocompetent individuals.
- This case highlights the potential for effective antibiotic-only management of complex liver abscesses.
