Infected hepatic cyst complicating urinary sepsis

Area of Science:

• Hepatology
• Infectious Diseases
• Radiology

Background:

• Congenital hepatic cysts are typically benign and asymptomatic.
• Complications, though rare, can be severe, necessitating prompt medical intervention.

Observation:

• An 86-year-old female presented with epigastric pain, fever, and chills, indicative of sepsis.
• Elevated inflammatory markers (neutrophils, C-reactive protein, procalcitonin) and liver enzymes were noted.
• Imaging revealed an 11 cm infected solitary hepatic cyst secondary to urinary tract infection.

Findings:

• The patient was treated with intravenous amoxicillin clavulanic acid, followed by oral clindamycin.
• Percutaneous drainage of the infected hepatic cyst was performed under CT guidance.
• Cultures identified Escherichia coli and Streptococcus constellatus, consistent with the urinary sepsis source.

Implications:

• This case highlights the importance of considering hepatic cyst infection in patients with sepsis of unknown origin.
• Percutaneous drainage combined with targeted antibiotics is an effective treatment for infected hepatic cysts.
• Early diagnosis and intervention can prevent severe morbidity associated with complicated hepatic cysts.