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Successful cure of multiple large, inoperable liver abscesses by antibiotic therapy
Sarah Niederreiter1, Andreas Voelkerer2, Christian Datz2
1Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, Innsbruck, A-6020, Austria.
Purpose:
Pyogenic liver abscesses are challenging due to their diverse etiology and the risk of severe complications. In many cases, surgical interventions are initiated. However, these are only applicable in selected scenarios. We report the case of a 63-year-old woman with multiple large liver abscesses of up to 6.7 cm spread across both liver lobes, which could not be managed surgically.
Methods & Results:
Streptococcus intermedius was isolated in blood culture and PCR positivity for this pathogen was obtained in liver puncture specimen. Following a two-weeks course of intravenous therapy with cefuroxime, metronidazole and fosfomycin, the patients received a consecutive, combined oral antibiotic treatment with clindamycin and cephalexin for four months. This resulted in complete resolution of the abscesses, with no evidence of relapse at follow-up.
Conclusion:
This case illustrates the complex therapeutic challenges in the management of multiple, large hepatic abscesses, highlighting the potential of antibiotic therapy to cure even inoperable patients.
