Related Experiment Videos
[Pyogenic liver abscess in children]
R Spiegel1, D Miron, Y Horovitz
1Dept. of Pediatrics A, HaEmek Medical Center, Afula.
Insights
Pyogenic liver abscesses in children are rare but treatable. Prompt diagnosis and appropriate antibiotic therapy, sometimes with abscess drainage, lead to successful outcomes, even in complex cases.
Area of Science:
- Pediatric Infectious Diseases
- Hepatology
- Microbiology
Background:
- Pyogenic liver abscesses are uncommon in children, often presenting with non-specific symptoms.
- Prompt diagnosis and management are crucial for favorable outcomes.
Observation:
- A 6-year-old boy presented with fever and hepatomegaly, diagnosed with a large right hepatic lobe abscess caused by Streptococcus milleri.
- A 4-month-old girl had prolonged fever, osteomyelitis, and bilateral liver abscesses, later found to have chronic granulomatous disease.
Findings:
- Both pediatric patients with pyogenic liver abscesses achieved successful treatment outcomes.
- The 6-year-old boy responded to abscess drainage and targeted antibiotic therapy.
- The infant with underlying chronic granulomatous disease was successfully treated with broad-spectrum antibiotics.
Implications:
- This case series highlights the importance of considering pyogenic liver abscesses in febrile children.
- Effective management involves a combination of antimicrobial agents and, when necessary, interventional procedures.
- Identifying underlying immunodeficiencies, such as chronic granulomatous disease, is critical for comprehensive patient care.
Abstract:
2 children with pyogenic liver abscesses were hospitalized during the past 2 years. A 6-year-old boy had high fever and hepatomegaly, and a large liver abscess was found in the right hepatic lobe. Streptococcus milleri was isolated from the pus. Treatment with a combination of prolonged drainage of the abscess and antibiotic therapy was successful. A 4-month-old girl who had prolonged fever was found to have osteomyelitis of 3 thoracic vertebrae and 2 liver abscesses in the right lobe. She was treated successfully with broad spectrum antibiotics. Additional workup revealed that she had chronic granulomatous disease.