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Cryptogenic hepatic abscess in two uncompromised children

E Harrington, M A Bleicher

    Journal of Pediatric Surgery
    |October 1, 1980
    PubMed
    Summary

    Cryptogenic liver abscesses in children are rare but should be considered for unexplained fevers. Prompt diagnosis and drainage are key for recovery, even without an identified cause.

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    Area of Science:

    • Pediatric Infectious Diseases
    • Hepatology
    • Microbiology

    Background:

    • Cryptogenic liver abscesses are uncommon in pediatric patients.
    • Pyrexia of unknown origin (PUO) necessitates a broad differential diagnosis in children.
    • Early consideration of hepatic abscess is crucial for timely intervention.

    Observation:

    • Two previously healthy children presented with suspected liver abscesses.
    • Diagnostic imaging (radioisotopic, sonographic, angiographic) supported the clinical suspicion.
    • Surgical drainage was performed, revealing pure cultures of anaerobic bacteria (microaerophilic streptococcus and Fusobacterium necrophorum).

    Findings:

    • The exact source and cause of the liver abscesses remained undetermined in both cases.
    • Isolation of specific anaerobic bacteria highlights their potential role in pediatric liver abscesses.
    • Successful treatment involved prompt diagnosis, surgical drainage, and appropriate antibiotic therapy.

    Implications:

    • This case series underscores the importance of considering cryptogenic liver abscesses in children with PUO.
    • Hepatic abscesses can occur in otherwise healthy children, with or without mild gastrointestinal symptoms or underlying conditions like sickle cell disease.
    • Effective management relies on high clinical suspicion, thorough investigation, surgical intervention, and targeted antimicrobial treatment.

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