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Hepatic abscess presenting as severe fatigue and anemia
1Group Health Association, Tysons Corner Medical Center, Vienna, Va.
Archives of Family Medicine
|February 1, 1993
Summary
Severe anemia can be the first sign of a pyogenic hepatic abscess, even without typical symptoms like fever or pain. This rare presentation highlights the importance of considering liver abscesses in unexplained anemia cases.
Area of Science:
- Internal Medicine
- Gastroenterology
- Infectious Diseases
Background:
- Pyogenic hepatic abscesses are typically associated with symptoms such as fever, right upper quadrant pain, and malaise.
- Anemia is a common finding in patients with pyogenic hepatic abscesses, though usually mild.
Observation:
- A 54-year-old woman presented with severe anemia as the sole initial symptom of a pyogenic hepatic abscess.
- She denied fever and gastrointestinal symptoms, with only anorexia noted.
- The hepatic abscess was discovered during an evaluation for occult malignancy as the cause of her anemia.
Findings:
- A comprehensive literature search revealed no prior reports of pyogenic hepatic abscesses presenting solely with anemia and fatigue.
- This case represents a rare instance of anemia without the characteristic symptoms of hepatic abscess.
Implications:
- Physicians should consider pyogenic hepatic abscess as a potential cause of severe anemia, even in the absence of typical symptoms.
- This case underscores the importance of a thorough diagnostic workup for unexplained anemia, including imaging to rule out intra-abdominal pathology.