Community-Acquired Methicillin-Resistant Staphylococcus Aureus Hepatic Liver Abscess

Area of Science:

• Infectious Diseases
• Hepatology
• Radiology

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) liver abscesses are rare and potentially fatal infections.
• Limited literature exists on the etiologies of MRSA liver abscesses, whether nosocomial or community-acquired.

Observation:

• A 45-year-old male with a significant smoking history presented with abdominal pain and cough.
• Leukocytosis, elevated liver enzymes (ALT), and imaging confirmed a multiloculated liver abscess and right perihilar consolidation.
• Percutaneous drainage yielded MRSA, necessitating antibiotic treatment.

Findings:

• Initial treatment with vancomycin led to symptom resolution and decreased leukocytosis.
• Recurrent liver enzyme elevations prompted a combined regimen of vancomycin and ciprofloxacin.
• This dual therapy resulted in normalization of liver function tests and absence of recurrence.

Implications:

• High clinical suspicion for liver abscess is warranted in patients with abdominal pain and elevated liver function tests, especially with a history of prior infection.
• Prompt diagnosis and appropriate management, including targeted antibiotics and drainage, are essential for favorable outcomes in MRSA liver abscess cases.
• This case highlights the importance of considering MRSA in liver abscess etiology and the potential efficacy of combination antibiotic therapy.