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[Chronic septic granulomatosis. Disclosed by hepatic abscesses. Contribution of echography]
Insights
Chronic granulomatous disease (CGD) typically presents with skin infections. This case highlights early liver abscesses in an infant, successfully treated with antibiotics and drainage.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Hepatology
Background:
- Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder.
- Common CGD manifestations in infancy include skin infections and lymph node abscesses.
- Intrahepatic abscesses are typically observed later in the disease course.
Observation:
- A 4-month-old infant presented with initial symptoms of liver abscesses, an atypical presentation for CGD.
- Ultrasonography guided percutaneous needle aspiration of the liver abscesses.
- Isolation of Staphylococcus aureus from the abscess aspirate.
Findings:
- The infant's CGD manifested initially with intrahepatic abscesses.
- Percutaneous aspiration successfully identified Staphylococcus aureus as the causative pathogen.
- The infant showed partial regression of abscesses following aspiration and antibiotic treatment.
Implications:
- This case underscores the variability in CGD presentation, emphasizing the need for early diagnosis.
- Minimally invasive procedures like percutaneous aspiration can be crucial for diagnosis and initial management.
- Conservative management, including antibiotics and drainage, may obviate the need for surgery in select CGD cases.
Abstract:
Skin infections and lymph node abscesses are the most common manifestations of chronic granulomatous disease (CGD) during the first year of life. Intra-hepatic abscesses occur later on. The case reported concerns a 4 month-old infant, in whom the disease presented initially with liver abscesses. Percutaneous needle aspiration of the liver under ultrasonographic control permitted the isolation of Staphylococcus aureus and allowed partial regression of the abscesses. Surgery was not required.