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Sun J, Mi X, Ye X, ShenTu Y, Liu C, Tang D, Yang W, Yang J, Ye X, Ma X, Shi J, Chen G, Gong L. Biliary sepsis complication with congenital hepatic fibrosis: an unexpected outcome. BMC Infect Dis 2023; 23:715. [PMID: 37872485 PMCID: PMC10591346 DOI: 10.1186/s12879-023-08681-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/07/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND CHF (Congenital hepatic fibrosis) is a rare hereditary disease characterized by periportal fibrosis and ductal plate malformation. Little is known about the clinical presentations and outcome in CHF patients with an extraordinary complication with biliary sepsis. Our case described a 23-year-old female diagnosed as CHF combined with biliary sepsis. Her blood culture was positive for KP (Klebsiella pneumoniae), and with a high level of CA19-9 (> 1200.00 U/ml, ref: <37.00 U/ml). Meanwhile, her imaging examinations showed intrahepatic bile duct dilatation, portal hypertension, splenomegaly, and renal cysts. Liver pathology revealed periportal fibrosis and irregularly shaped proliferating bile ducts. Whole-exome sequencing identified two heterozygous missense variants c.3860T > G (p. V1287G) and c.9059T > C (p. L3020P) in PKHD1 gene. After biliary sepsis relieved, her liver function test was normal, and imaging examination results showed no significant difference with the results harvested during her biliary sepsis occurred. CONCLUSION The diagnosis of CHF complicated with biliary sepsis in the patient was made. Severely biliary sepsis due to KP infection may not inevitably aggravate congential liver abnormality in young patients. Our case provides a good reference for timely treatment of CHF patients with biliary sepsis.
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Affiliation(s)
- Jiawei Sun
- Hangzhou Normal University, Zhejiang, China
| | - Xiaoxiao Mi
- Institute of Translational Medicine, The Affiliated Hospital of Hangzhou Normal University, Zhejiang, China
| | | | - Yiling ShenTu
- Department of Respiratory Medicine, Fuyang First People's Hospital, Hangzhou, China
| | - Chun Liu
- Hangzhou Normal University, Zhejiang, China
| | - Dong Tang
- Department of Medical Imaging (Radiology), The Affiliated Hospital of Hangzhou Normal University, Zhejiang, China
| | - WenJun Yang
- Department of Pathology, The Affiliated Hospital of Hangzhou Normal University, Zhejiang, China
| | - Jie Yang
- Department of Infectious Disease (Liver Diseases), Lishui Municipal Central Hospital, Zhejiang, China
| | - Xiaoping Ye
- Department of Infectious Disease (Liver Diseases), The Affiliated Hospital of Hangzhou Normal University, Zhejiang, 310015, China
| | - Xiaojie Ma
- Department of Infectious Disease (Liver Diseases), The Affiliated Hospital of Hangzhou Normal University, Zhejiang, 310015, China
| | - Junping Shi
- Department of Infectious Disease (Liver Diseases), The Affiliated Hospital of Hangzhou Normal University, Zhejiang, 310015, China
| | - Gongying Chen
- Department of Infectious Disease (Liver Diseases), The Affiliated Hospital of Hangzhou Normal University, Zhejiang, 310015, China
| | - Ling Gong
- Department of Infectious Disease (Liver Diseases), The Affiliated Hospital of Hangzhou Normal University, Zhejiang, 310015, China.
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