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Is "primary" subphrenic abscess caused by Streptococcus milleri a result of unrecognized gastrointestinal
Klinische Wochenschrift
|March 17, 1986
Abstract:
An unusual case of subphrenic abscess presenting as empyema of the pleural cavity is described. The abscess developed secondarily to an occult perforation of the gastrointestinal tract, which was, diagnosed indirectly by the discovery of a fishbone within the abscess. Isolation of Streptococcus milleri from the pus was an important clue for the existence of an underlying gastrointestinal pathology.
Insights
A subphrenic abscess mimicked empyema due to a hidden gastrointestinal perforation. A fishbone in the abscess and Streptococcus milleri in pus confirmed the gastrointestinal origin.
Area of Science:
- Gastroenterology
- Thoracic Surgery
- Infectious Diseases
Background:
- Subphrenic abscesses typically present with abdominal pain and fever.
- Empyema usually results from pneumonia or thoracic surgery.
- Occult gastrointestinal perforations can lead to intra-abdominal infections.
Observation:
- A patient presented with symptoms suggestive of empyema.
- Imaging revealed a subphrenic abscess.
- A fishbone was discovered within the abscess cavity.
Findings:
- The subphrenic abscess was secondary to an occult gastrointestinal tract perforation.
- Streptococcus milleri isolated from the abscess pus indicated underlying gastrointestinal pathology.
- The presentation mimicked empyema of the pleural cavity.
Implications:
- This case highlights the importance of considering gastrointestinal pathology in unusual presentations of thoracic infections.
- Diagnostic clues like foreign bodies (fishbone) and specific bacteria (Streptococcus milleri) can be crucial.
- Early recognition and management of occult perforations are vital to prevent severe complications.