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Oral chloramphenicol therapy for multiple liver abscesses in hyperimmunoglobulinemia E syndrome
European Journal of Pediatrics
|September 1, 1984
Abstract:
In a patient with Hyper-IgE-syndrome multiple liver abscesses developed in spite of prophylactic treatment with trimethoprim and sulfamethoxazol. Ultrasound confirmed the clinical diagnosis and percutaneous needle aspiration under ultrasonographic guidance and culture of the aspirated pus allowed specific antibiotic treatment by oral chloramphenicol alone without surgical drainage. The isolated Staph.aureus strain was resistant to trimethoprim and sulfamethoxazol.
Insights
Hyper-IgE syndrome patients can develop liver abscesses resistant to common antibiotics. Ultrasound-guided aspiration enabled targeted treatment with chloramphenicol, avoiding surgery.
Area of Science:
- Immunology
- Infectious Diseases
- Hepatology
Background:
- Hyper-IgE syndrome (HIES) is a primary immunodeficiency characterized by elevated IgE levels and recurrent infections.
- Liver abscesses are a rare but serious complication in HIES patients, often requiring aggressive management.
Observation:
- A patient with HIES presented with multiple liver abscesses despite prophylactic trimethoprim/sulfamethoxazole treatment.
- The causative Staphylococcus aureus strain exhibited resistance to trimethoprim and sulfamethoxazole.
Findings:
- Ultrasound-guided percutaneous needle aspiration successfully diagnosed the liver abscesses.
- Culture-guided antibiotic therapy with oral chloramphenicol achieved successful treatment without surgical intervention.
- This highlights the importance of microbiological culture for guiding therapy in resistant infections.
Implications:
- Percutaneous aspiration is a valuable diagnostic and therapeutic tool for liver abscesses in HIES.
- Tailored antibiotic selection based on culture sensitivity is crucial for managing resistant Staph. aureus infections in immunocompromised patients.
- This approach may obviate the need for surgical drainage in select cases, improving patient outcomes.