1
|
Hafner S, Seufferlein T, Kleger A, Müller M. Symptoms and Management of Aseptic Liver Abscesses. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2024; 62:208-217. [PMID: 37827501 DOI: 10.1055/a-2075-5082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Aseptic liver abscesses occur very rarely. Clinical guidelines on the management of the disease do not exist, and the diagnosis is challenging.We screen MEDLINE and PUBMED databases for relevant case reports from inception to November 2022. Information on patient age, sex, initial symptoms, the extent of abscess formation, further diagnoses, treatment, and course of the disease is analyzed.Thirty cases with sterile hepatic abscess formation are identified. In most patients (n=18), the spleen is affected as well. Patients typically present with fever, abdominal pain, and increased inflammatory values. Comorbidity with inflammatory bowel disease is very common (n=18) and is associated with a significantly younger age at the time of hepatic abscess development. In addition, many patients show autoimmune-mediated cutaneous, ocular, or arthritic rheumatoid manifestations. Histological examination of abscess material reveals neutrophilic infiltration. The majority of patients initially receive corticosteroid therapy. Furthermore, response to azathioprine, anti-TNF-α antibodies, and other immunomodulatory drugs is reported. Ten out of fourteen patients with a long-term follow-up (≥ 36 months) have at least one relapse of hepatic abscess formation.Aseptic hepatic abscesses should be considered in the case of sterile punctures and non-response to antibiotics. Patients with aseptic liver abscesses have a high risk of recurrence warranting immunomodulatory maintenance therapy.
Collapse
Affiliation(s)
- Susanne Hafner
- Institute of Experimental and Clinical Pharmacology, Toxicology and Pharmacology of Natural Products, University Ulm Medical Centre, Ulm, Germany
| | | | - Alexander Kleger
- Internal Medicine I, University Ulm Medical Centre, Ulm, Germany
| | - Martin Müller
- Internal Medicine I, University Ulm Medical Centre, Ulm, Germany
| |
Collapse
|
2
|
Dias PR, Bolt L, Iking-Konert C, Arrigo M, Huber LC. Multiple Abscess Collections: Antibiotics or Steroids? Case Reports Immunol 2024; 2024:3671685. [PMID: 38304552 PMCID: PMC10834088 DOI: 10.1155/2024/3671685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/27/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
Aseptic abscess syndrome (AAS) is a medical rarity. The combination of multiple abscess collections in different organs, negative microbiological studies, and the association with an inflammatory bowel disease is highly suggestive for an AAS. The AAS is an acute neutrophilic dermatosis, so "generalized pyoderma gangraenosum" or "generalized bullous sweet syndrome" might be used synonymously. It is important to note that the diagnosis of an AAS can be made only after careful exclusion of an infectious disease. Of interest, despite the severity of the inflammation, patients with AAS are commonly hemodynamically stable. To date, no studies have investigated the optimal regimen, dose, and duration of therapy. Corticosteroids are the cornerstone of immunosuppression during the acute phase. After the induction phase, therapy might be switched to anakinra or infliximab.
Collapse
Affiliation(s)
| | - Levin Bolt
- Department of Internal Medicine, Stadtspital Zurich Triemli, Zurich, Switzerland
| | | | - Mattia Arrigo
- Department of Internal Medicine, Stadtspital Zurich Triemli, Zurich, Switzerland
| | - Lars C. Huber
- Department of Internal Medicine, Stadtspital Zurich Triemli, Zurich, Switzerland
| |
Collapse
|
3
|
Kim CG, Kim YJ, Lee S, Kim TH, Kim H. Aseptic abscess associated with SAPHO syndrome: a case report. Skeletal Radiol 2023:10.1007/s00256-023-04493-3. [PMID: 37889316 DOI: 10.1007/s00256-023-04493-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
Aseptic abscess (AA) is a rare autoinflammatory disorder, characterized by the formation of sterile abscesses in various organs, and is accompanied by inflammatory bowel disease. Antibiotic treatment is ineffective, but steroid therapy shows a good response. AA can be difficult to differentiate from infection because abscesses appear similar both radiologically and histopathologically. Herein, we present the case of a 56-year-old woman with AA in the anterior chest wall and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome.
Collapse
Affiliation(s)
- Chang Guk Kim
- Department of Radiology, School of Medicine, Hanyang University Hospital, 222-1, Wangsimni-Ro Seongdong-Gu, Seoul, 04763, South Korea
| | - Yeo Ju Kim
- Department of Radiology, School of Medicine, Hanyang University Hospital, 222-1, Wangsimni-Ro Seongdong-Gu, Seoul, 04763, South Korea.
| | - Seunghun Lee
- Department of Radiology, School of Medicine, Hanyang University Hospital, 222-1, Wangsimni-Ro Seongdong-Gu, Seoul, 04763, South Korea
| | - Tae-Hwan Kim
- Division of Rheumatology, School of Medicine, Hanyang University Hospital, Seoul, 04763, South Korea
| | - Hyunsung Kim
- Department of Pathology, School of Medicine, Hanyang University Hospital, Seoul, 04763, South Korea
| |
Collapse
|
4
|
Alshammary SA, Boumarah DN. Hepatic Abscess in Inflammatory Bowel Disease: A Systematic Scoping Review of an Overlooked Entity. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:267-274. [PMID: 37970456 PMCID: PMC10634461 DOI: 10.4103/sjmms.sjmms_545_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/24/2023] [Accepted: 07/05/2023] [Indexed: 11/17/2023]
Abstract
Background Liver abscess is one of the hepatobiliary manifestations of inflammatory bowel disease (IBD) that has been scarcely described in the literature. Objectives To conduct a scoping review to provide a detailed description of the occurrence of hepatic abscess in patients with IBD and summarize the observed clinical features. Methodology Searches were carried out using relevant keywords in Medline (via PubMed) and Web of Science from inception until June 13, 2022. Only articles that reported the occurrence of hepatic abscess in patients with IBD were included. Results Forty-eight publications (40 case reports and 8 case series) were included, representing 73 patients with IBD who were radiologically or intraoperatively diagnosed with hepatic abscess. Patients with Crohn's disease were more predisposed to developing hepatic abscess than patients with ulcerative colitis (79.5% vs. 20.5%, respectively). Furthermore, pyogenic liver abscess was found to be more prevalent (57.9%) compared with aseptic (38.7%) and amebic (3.2%) abscesses. No clear relation was found between death or prolonged hospital stay in terms of the clinical presentation or management plan, as mortality was reported in different age groups with different managements. Conclusion To date, there is no consensus regarding the appropriate management of hepatic abscess as an extraintestinal manifestation of IBD. However, the condition shares several features with liver abscess diagnosed among the general population.
Collapse
Affiliation(s)
- Shadi Abdullah Alshammary
- Department of Surgery, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dhuha Nahar Boumarah
- Department of Surgery, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
5
|
Jazeer M, Antony D, Pakkiyaretnam M. Aseptic Abscess of the Spleen as an Antecedent Manifestation of Behçet's Disease. Cureus 2023; 15:e38375. [PMID: 37265896 PMCID: PMC10230598 DOI: 10.7759/cureus.38375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 06/03/2023] Open
Abstract
Behçet's disease (BD) is a multisystem autoimmune vasculitis that manifests as oral and genital ulcers with varying degrees of dermatological and ocular involvement. Aseptic splenic abscesses are a rare entity commonly occurring in autoinflammatory diseases and are rarely associated with BD. Here, we present the case of a 16-year-old male with BD who presented with prolonged fever and constitutional symptoms and was found to have an aseptic splenic abscess. Rapid resolution of the symptoms along with radiological evidence of abscess shrinkage was achieved with corticosteroid therapy.
Collapse
Affiliation(s)
- Mohamed Jazeer
- Internal Medicine, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Diroji Antony
- University Medical Unit, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Mayurathan Pakkiyaretnam
- University Medical Unit, Teaching Hospital Batticaloa, Batticaloa, LKA
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
| |
Collapse
|
6
|
Toba T, Ikegami R, Nogami A, Watanabe N, Fujii K, Ogawa Y, Hojo A, Fujimoto A, Matsuda T. Multiple ulcerative colitis-associated aseptic abscesses successfully treated with infliximab: a case report. Clin J Gastroenterol 2023:10.1007/s12328-023-01807-9. [PMID: 37097421 DOI: 10.1007/s12328-023-01807-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
Aseptic abscesses are rare extraintestinal manifestations of inflammatory bowel disease. Herein, we present the case of a 69-year-old female patient with ulcerative colitis in whom multiple aseptic abscesses were successfully treated with infliximab. Aseptic abscesses associated with ulcerative colitis are difficult to differentiate from infectious abscesses. In the present case, we reached a diagnosis of aseptic abscesses associated with ulcerative colitis as antibiotics were ineffective and repeated Gram stains and cultures of blood and abscess were negative. Aseptic abscesses are commonly found in the spleen, lymph nodes, liver, and skin; however, in the present case, the periosteum was the major site. Prednisolone is often effective for aseptic abscesses; however, the present patient was initially treated with a combination of 40 mg/day of prednisolone and granulocyte and monocyte adsorption apheresis, with inadequate effect. Infliximab was administered as the patient was steroid-resistant, with strong effect. Subsequently, infliximab treatment has been continued, with no recurrence after 2 years. However, as there have been reports of cases of recurrence even after remission with treatment, careful follow-up in the future is therefore necessary.
Collapse
Affiliation(s)
- Takahito Toba
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan.
| | - Ryo Ikegami
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Akira Nogami
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Naoko Watanabe
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Kodai Fujii
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Yurie Ogawa
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Aya Hojo
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Ai Fujimoto
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Takahisa Matsuda
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| |
Collapse
|
7
|
Habeeb TAAM, Hussain A, Podda M, Cianci P, Ramshaw B, Safwat K, Amr WM, Wasefy T, Fiad AA, Mansour MI, Moursi AM, Osman G, Qasem A, Fawzy M, Alsaad MIA, Kalmoush AE, Nassar MS, Mustafa FM, Badawy MHM, Hamdy A, Elbelkasi H, Mousa B, Metwalli AEM, Mawla WA, Elaidy MM, Baghdadi MA, Raafat A. Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study. World J Gastrointest Surg 2023; 15:234-248. [PMID: 36896298 PMCID: PMC9988646 DOI: 10.4240/wjgs.v15.i2.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/05/2023] [Accepted: 02/03/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Hepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated.
AIM To evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC.
METHODS Between June 2013 and June 2018, 167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study. Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study. The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations.
RESULTS The patients' mean age was 36 ± 8 years, and males predominated (67.1%). The most common hepatobiliary diagnostic method was liver biopsy (85.6%), followed by Magnetic resonance cholangiopancreatography (63.5%), Antineutrophil cytoplasmic antibodies (62.5%), abdominal ultrasonography (35.9%), and Endoscopic retrograde cholangiopancreatography (6%). The most common hepatobiliary symptom was Primary sclerosing cholangitis (PSC) (62.3%), followed by fatty liver (16.8%) and gallbladder stone (10.2%). 66.4% of patients showed a stable course after surgery. Progressive or regressive courses occurred in 16.8% of each. Mortality was 6%, and recurrence or progression of symptoms required surgery for 15%. Most PSC patients (87.5%) had a stable course, and only 12.5% became worse. Two-thirds (64.3%) of fatty liver patients showed a regressive course, while one-third (35.7%) showed a stable course. Survival rates were 98.8%, 97%, 95.8%, and 94% at 12 mo, 24 mo, 36 mo, and at the end of the follow-up.
CONCLUSION In patients with UC who had LRP, there is a positive impact on hepatobiliary disease. It caused an improvement in PSC and fatty liver disease. The most prevalent unchanged course was PSC, while the most common improvement was fatty liver disease.
Collapse
Affiliation(s)
- Tamer A A M Habeeb
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | | | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Cagliari 2432, Italy
| | - Pasquale Cianci
- Department of Medical and Surgical Sciences, Università degli studi di Foggia, Foggia 546, Italy
| | - Bruce Ramshaw
- MD CQInsights PBC, Co-founder & CEO, Tennessee, TN 37010, United States
| | - Khaled Safwat
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Wesam M Amr
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Tamer Wasefy
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Alaa A Fiad
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Mohamed Ibrahim Mansour
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Adel Mahmoud Moursi
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Gamal Osman
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Anass Qasem
- Department of Internal Medicine, Zagazig University, Zagazig 2355, Egypt
| | - Mohamed Fawzy
- Department of Internal Medicine, Suez University, Suez 235, Egypt
| | | | | | | | - Fawzy M Mustafa
- Department of General Surgery, Al-azhar University, Cairo 285, Egypt
| | | | - Ahmed Hamdy
- Department of Hepato-Bilio-Pancreatic (HBP) Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo 285, Egypt
| | - Hamdi Elbelkasi
- Department of General Surgery, Mataryia Teaching Hospital, Cairo 285, Egypt
| | - Bassam Mousa
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Abd-Elrahman M Metwalli
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Walid A Mawla
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Mostafa M Elaidy
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Muhammad Ali Baghdadi
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| | - Ahmed Raafat
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig 44759, Sharkia, Egypt
| |
Collapse
|
8
|
Aseptic splenic abscesses as the inaugural manifestation of Crohn's disease. Clin Res Hepatol Gastroenterol 2022; 46:101989. [PMID: 35792238 DOI: 10.1016/j.clinre.2022.101989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023]
|
9
|
Terrier J, Relecom A, Borgeaud S, Bridel C, Seebach J, Assal F, Reny JL, Serratrice J. A bilateral aseptic pyogenic ventriculitis following a course of pembrolizumab, an anti-PD-1 immune checkpoint inhibitor treatment for metastatic small cell lung cancer. Therapie 2022; 77:754-756. [PMID: 35660110 DOI: 10.1016/j.therap.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/27/2022] [Accepted: 05/09/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Jean Terrier
- Division of General Internal Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland; Geneva Platelet Group, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; Clinical Pharmacology and Toxicology Division, Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine Department, Geneva University Hospitals, 1205 Geneva, Switzerland.
| | - Alan Relecom
- Medical Oncology Division, Oncology Department, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Simon Borgeaud
- Division of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Claire Bridel
- Division of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Jörg Seebach
- Division of Immunology and Allergology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Frédéric Assal
- Division of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Jean-Luc Reny
- Division of General Internal Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland; Geneva Platelet Group, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Jacques Serratrice
- Division of General Internal Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| |
Collapse
|
10
|
Nasri I, Ramdani Y, Lemaignen A, Ferreira-Maldent N, Bigot A, Boucaud A, Maillot F, Audemard-Verger A. [Multiple liver lesions]. Rev Med Interne 2021; 43:57-58. [PMID: 34922782 DOI: 10.1016/j.revmed.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/30/2021] [Indexed: 11/16/2022]
Affiliation(s)
- I Nasri
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - Y Ramdani
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France; Service de maladies infectieuses, CHRU Tours, Tours, France
| | - A Lemaignen
- Service de maladies infectieuses, CHRU Tours, Tours, France; Université de Tours, Tours, France
| | - N Ferreira-Maldent
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - A Bigot
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - A Boucaud
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - F Maillot
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France; Service de maladies infectieuses, CHRU Tours, Tours, France
| | - A Audemard-Verger
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France; Service de maladies infectieuses, CHRU Tours, Tours, France.
| |
Collapse
|
11
|
Dhruv S, Anwar S, Polavarapu A, Yousaf F, Mukherjee I. Recurrent aseptic liver abscesses in a patient with Crohn's disease: True infection or a Crohn's flare? Arab J Gastroenterol 2021; 23:58-60. [PMID: 34838482 DOI: 10.1016/j.ajg.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/02/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
A liver abscess is identified as a rare extraintestinal manifestation of Crohn's disease, with an incidence of approximately 150 in 100,000 patients with this condition. In many of these patients, infectious causes are identified, and the patient's condition is often noted to improve with antibiotics. An aseptic abscess (AA) is an increasingly recognized entity, especially in patients with inflammatory bowel disease, where repetitive evaluations to identify the infectious cause are futile. The average age of diagnosis for an AA is 29 years. The most common site is the spleen, followed by the lymph nodes and then the liver. In this study, we present a unique case of extensive aseptic liver abscesses extending into the pleural cavity in a young patient with Crohn's disease.
Collapse
Affiliation(s)
- Samyak Dhruv
- Staten Island University Hospital, Internal Medicine, NY, USA
| | | | | | - Fahad Yousaf
- Staten Island University Hospital, Internal Medicine, NY, USA
| | | |
Collapse
|
12
|
Sheehan JL, Brandler J, Rice MD. A Case of Recurrent Hepatic Abscesses. Gastroenterology 2021; 161:1393-1394. [PMID: 33839097 DOI: 10.1053/j.gastro.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/28/2021] [Accepted: 04/05/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Jessica L Sheehan
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan.
| | - Justin Brandler
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, Michigan
| | - Michael D Rice
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, Michigan
| |
Collapse
|
13
|
|
14
|
Shimizu MS, Matsuo T, Mori N. A Rare Manifestation Associated With a Urinary Tract Infection in a Patient With Ulcerative Colitis. Gastroenterology 2021; 161:e14-e15. [PMID: 33359092 DOI: 10.1053/j.gastro.2020.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/11/2020] [Indexed: 12/02/2022]
Affiliation(s)
| | - Takahiro Matsuo
- Department of Infectious Diseases, St Luke's International Hospital, Tokyo, Japan
| | - Nobuyoshi Mori
- Department of Infectious Diseases, St Luke's International Hospital, Tokyo, Japan
| |
Collapse
|
15
|
Hafner S, Seufferlein T, Kleger A, Müller M. Aseptic Liver Abscesses as an Exceptional Finding in Cogan's Syndrome. Hepatology 2021; 73:2067-2070. [PMID: 32916761 DOI: 10.1002/hep.31547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/07/2022]
Affiliation(s)
- Susanne Hafner
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | | | | | - Martin Müller
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| |
Collapse
|
16
|
Kukimoto N, Honda N, Yokogawa N, Ohno-Tanaka A. Sterile subconjunctival abscess in an HLA-B51-positive patient with ulcerative colitis. Am J Ophthalmol Case Rep 2021; 22:101033. [PMID: 33659764 PMCID: PMC7896157 DOI: 10.1016/j.ajoc.2021.101033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/29/2020] [Accepted: 02/02/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose To report a rare case of aseptic abscess presenting as a subconjunctival abscess in an HLA-B51-positive patient with ulcerative colitis. Observations A 25-year-old, male, Japanese patient with ulcerative colitis presented with an unilateral subconjunctival abscess. Infective endocarditis with endophthalmitis was suspected of being the cause, and systemic antimicrobial therapy was begun. The patient became critically ill and experienced the complication of heart failure with mitral valve perforation but improved dramatically with high-dose corticosteroids and intravenous infliximab following mitral valvuloplasty. His HLA typing was positive for HLA-B51. Conclusions and importance Both infectious and non-infectious etiologies should be considered in a patient with a subconjunctival abscess with systemic inflammation. An aseptic abscess can present as a subconjunctival abscess, and HLA-B51 may play a role in the pathogenesis of this rare condition.
Collapse
Affiliation(s)
- Nobuyuki Kukimoto
- Department of Ophthalmology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Nanase Honda
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Akiko Ohno-Tanaka
- Department of Ophthalmology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| |
Collapse
|
17
|
Yamaguchi Y, Nakagawa M, Nakagawa S, Nagao K, Inoue S, Sugiyama T, Izawa S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Rapidly Progressing Aseptic Abscesses in a Patient with Ulcerative Colitis. Intern Med 2021; 60:725-730. [PMID: 32999240 PMCID: PMC7990631 DOI: 10.2169/internalmedicine.5733-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aseptic abscesses (AAs) are extraintestinal manifestations of inflammatory bowel disease (IBD). IBD-associated AAs are rare in Japan. We treated a 45-year-old man with ulcerative colitis (UC)-associated AAs. During remission, multiple progressive abscesses were detected in the spleen; he underwent splenectomy because an infectious disease was suspected. Although his condition improved temporarily after splenectomy, a large liver abscess was noted, and a diagnosis of UC-associated AAs was made. Granulocytapheresis (GCAP) and infliximab (IFX) administration resolved the abscess. This is the first reported case of UC-associated AAs in a Japanese patient treated by splenectomy, GCAP, and IFX.
Collapse
Affiliation(s)
- Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Marie Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shoko Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kazuhiro Nagao
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| |
Collapse
|
18
|
Soffer S, Dahan S, Maklakovski M, Dagan A. A Case of Aseptic Renal Abscesses Associated With IBD. Inflamm Bowel Dis 2021; 27:e28-e29. [PMID: 33155641 DOI: 10.1093/ibd/izaa284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Shelly Soffer
- Internal Medicine B, Assuta Medical Center, Ashdod, Israel, and Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Shani Dahan
- Internal Medicine B, Assuta Medical Center, Ashdod, Israel, and Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Marina Maklakovski
- Pathology Department, Assuta Medical Center, Ashdod, Israel, and Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Amir Dagan
- Internal Medicine B, Assuta Medical Center, Ashdod, Israel, and Ben-Gurion University of the Negev, Be'er Sheva, Israel
| |
Collapse
|
19
|
Abstract
A 43-year-old woman with Crohn's disease was admitted to the hospital with weight loss and 1 week of fever, abdominal pain and diarrhoea. At presentation, the patient was not on steroids or other immunosuppressive agents. Cross-sectional imaging of the abdomen revealed active colitis and multiple splenic and hepatic abscesses. All culture data were negative, including aspiration of purulent material from the spleen. Despite weeks of intravenous antibiotics, daily fever and abdominal pain persisted, the intra-abdominal abscesses grew, and she developed pleuritic chest pain and consolidations of the right lung. The patient was ultimately diagnosed with aseptic abscess syndrome, a rare sequelae of inflammatory bowel disease. All antimicrobials were discontinued and she was treated with high-dose intravenous steroids, resulting in rapid clinical improvement. She was transitioned to infliximab and azathioprine as an outpatient and repeat imaging demonstrated complete resolution of the deep abscesses that had involved her spleen, liver and lungs.
Collapse
Affiliation(s)
- Hannah Fillman
- School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Patricio Riquelme
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Peter D Sullivan
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - André Martin Mansoor
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| |
Collapse
|
20
|
Hostalrich A, Porterie J, Ricco JB, De Almeida S, Chaufour X. Complete aortic replacement in aortitis due to aseptic abscess syndrome. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:216-220. [PMID: 32368703 PMCID: PMC7184059 DOI: 10.1016/j.jvscit.2020.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 02/20/2020] [Indexed: 10/30/2022]
Abstract
A 36-year-old man was admitted for a tender inflammatory type IV thoracoabdominal aortic aneurysm with multiple aortic dilations. After open repair, he remained frail, but results of all infectious and inflammatory investigations were negative. Hypermetabolic intrasplenic collections were discovered on postoperative computed tomography, and aortitis with aseptic abscess syndrome was strongly suggested. Immunosuppressive therapy was undertaken, and his health improved dramatically. After 7 years of treatment, however, the initial aortic dilations had developed in size, necessitating multiple surgical procedures leading to complete aortic replacement. The postoperative course was uneventful with a satisfactory final computed tomography scan. Subsequent to immunotherapy, no new aneurysm developed.
Collapse
Affiliation(s)
- Aurélien Hostalrich
- Department of Vascular Surgery, Rangueil University Hospital, Toulouse, France
| | - Jean Porterie
- Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
| | - Jean Baptiste Ricco
- Department of Clinical Research, University Hospital of Poitiers, Poitiers, France
| | | | - Xavier Chaufour
- Department of Vascular Surgery, Rangueil University Hospital, Toulouse, France
| |
Collapse
|
21
|
Agirgol S, Ustaoglu E, Demir FT, Akbulut TO, Turkoglu Z, Kaya H, Pehlivanoğlu F. Aseptic Abscess Syndrome with Severe Skin Involvement: Case Report. Indian J Dermatol 2020; 65:434-436. [PMID: 33165447 PMCID: PMC7640788 DOI: 10.4103/ijd.ijd_259_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Senay Agirgol
- Dermatology Clinic, Haseki Training and Research Hospital, İstanbul, Turkey. E-mail:
| | - Eda Ustaoglu
- Dermatology Clinic, Haseki Training and Research Hospital, İstanbul, Turkey. E-mail:
| | - Filiz Topaloglu Demir
- Dermatology Clinic, Haseki Training and Research Hospital, İstanbul, Turkey. E-mail:
| | - Tugba Ozkok Akbulut
- Dermatology Clinic, Haseki Training and Research Hospital, İstanbul, Turkey. E-mail:
| | - Zafer Turkoglu
- Dermatology Clinic, Haseki Training and Research Hospital, İstanbul, Turkey. E-mail:
| | - Hasan Kaya
- Haseki Training and Research Hospital, Pathology Clinic, İstanbul, Turkey
| | - Filiz Pehlivanoğlu
- Haseki Training and Research Hospital, Infectious Disease Clinic, İstanbul, Turkey
| |
Collapse
|
22
|
Elessa D, Thietart S, Corpechot C, Fain O, Mekinian A. TNF-α antagonist infliximab for aseptic abscess syndrome. Presse Med 2019; 48:1579-1580. [PMID: 31757730 DOI: 10.1016/j.lpm.2019.09.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/19/2019] [Accepted: 09/30/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Dikelele Elessa
- AP-HP, hôpital Saint-Antoine, Sorbonne université, service de médecine interne et inflammation (DHUi2B), 75012 Paris, France
| | - Sara Thietart
- Assistance publique-hôpitaux de Paris, Saint-Antoine hospital, Sorbonne university, Saint-Antoine research center, reference center for inflammatory biliary diseases and autoimmune hepatitis, Inserm UMR_S938, 75012 Paris, France
| | - Christophe Corpechot
- Assistance publique-hôpitaux de Paris, Saint-Antoine hospital, Sorbonne university, Saint-Antoine research center, reference center for inflammatory biliary diseases and autoimmune hepatitis, Inserm UMR_S938, 75012 Paris, France
| | - Olivier Fain
- AP-HP, hôpital Saint-Antoine, Sorbonne université, service de médecine interne et inflammation (DHUi2B), 75012 Paris, France
| | - Arsene Mekinian
- AP-HP, hôpital Saint-Antoine, Sorbonne université, service de médecine interne et inflammation (DHUi2B), 75012 Paris, France.
| |
Collapse
|
23
|
Chang J. Saddle Nose Deformity as a Result of an Aseptic Nasal Abscess Accompanied by Ulcerative Colitis and Pyoderma Gangrenosum. JOURNAL OF RHINOLOGY 2018. [DOI: 10.18787/jr.2018.25.1.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Jinsoon Chang
- Department of Otolaryngology-Head and Neck Surgery, Inje University Seoul Paik Hospital, Seoul, Korea
| |
Collapse
|