Tuberculous liver abscess as a unique cause of liver abscess: A case report and literature review

Introduction

TLA is most commonly associated with an immunocompromised state, a focus of infection in the lungs or gastrointestinal system, or as part of congenital or miliary tuberculosis. Isolated TLA is rare, with only a few cases reported in the literature.

Methods

We describe a case of a 24-years-old healthy male with an isolated Tuberculous Liver abscess presented with prolonged fever, abdominal pain, and general malaise. He was successfully treated with a 6-month antituberculosis regimen and percutaneous abscess drainage.

Discussion and conclusion

The signs and symptoms of isolated TLA are nonspecific. The diagnosis requires a high index of suspicion, especially in endemic areas and in individuals with a known tuberculosis risk factor. A better outcome is linked to an early diagnosis and timely treatment with systemic Antituberculous medications. This case report highlights the importance of considering TLA (Tuberculous or Tubercular Liver Abscess) when diagnosing hepatic masses or abscesses as a possible cause of extrapulmonary tuberculosis (EPTB).

Outcomes and Effects of Hepatic Cirrhosis in Patients Who Underwent Transcatheter Aortic Valve Implantation

Comparative outcomes of transcatheter aortic valve implantation (TAVI) in patients with and without liver cirrhosis are scarce. This study aimed to assess the clinical outcomes and impact of liver cirrhosis on patients who underwent TAVI. Patient with liver cirrhosis who underwent TAVI 2011 to 2014 were identified in the National Inpatient Sample database using the International Classification of Diseases, ninth revision, Clinical Modification (ICD-9-CM). The primary outcome was the effect of liver cirrhosis on inpatient mortality. Secondary outcomes were the impact of liver cirrhosis on post-TAVI complications. We also evaluated the length of hospital stay and the cost of hospitalization. Propensity score-matched analysis was performed to address potential confounding. The cirrhotic patients who underwent TAVI had no significant increase in the risk of in-hospital mortality (odds ratio [OR] 1.12, 95% confidence interval [CI] 0.59 to 2.10, p = 0.734) or after procedural complications. Furthermore, cirrhotic patients were less likely to develop vascular complications requiring surgery (OR 0.47, 95% CI 0.23 to 0.98, p = 0.043), to develop after procedural deep vein thrombosis(OR <0.00, 95% CI <0.001 to <0.0001, p <0.0001), and to require pacemaker implantation. However, cirrhotic patients were more likely to undergo nonroutine hospital discharges (OR 1.50, 95% CI 1.15 to 1.96, p = 0.003). In conclusion, TAVI is a safe and reasonable therapeutic option for cirrhotic patients with severe aortic stenosis, requiring aortic valve replacement.