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Liver abscess in polycystic liver disease
P Assantachai1, P Luengrojanakul, R Phimolsarnti
1Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Summary
This case study highlights a rare instance of amebic liver abscess mimicking hepatic malignancy in an elderly patient. Prompt diagnosis and treatment led to a full recovery.
Area of Science:
- Infectious Diseases
- Hepatology
- Geriatric Medicine
Background:
- Elderly patients often present with atypical clinical manifestations due to physiological aging and comorbidities.
- Liver abscesses can mimic hepatic malignancies, complicating diagnosis, especially in geriatric populations.
Observation:
- An elderly female presented with a liver abscess that clinically and radiologically resembled hepatic malignancy.
- Initial investigations, including microscopy and blood/pus cultures, suggested a pyogenic abscess (Klebsiella spp.), with negative Entamoeba histolytica antibody tests.
- Intraoperative findings revealed adult polycystic liver disease and the presence of amebae within the liver abscess cavity.
Findings:
- Despite initial indications of a pyogenic abscess, the final pathology confirmed an amebic liver abscess.
- The patient received a combination of ceftriaxone and metronidazole, alongside surgical drainage.
Implications:
- This case underscores the importance of considering amebic liver abscess even with atypical presentations and negative serology in the elderly.
- Accurate diagnosis and timely, appropriate treatment are crucial for favorable outcomes in complex geriatric cases involving liver abscesses.