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O'Hara E, Zaheer R, Andrés-Lasheras S, McAllister TA, Gruninger RJ. Evaluating the liver abscess microbiota of beef cattle during a reduction in tylosin supplementation shows differences according to abscess size and fraction. FEMS Microbiol Ecol 2024; 100:fiae002. [PMID: 38373802 PMCID: PMC10960635 DOI: 10.1093/femsec/fiae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/04/2024] [Accepted: 02/19/2024] [Indexed: 02/21/2024] Open
Abstract
Liver abscesses (LA) resulting from bacterial infection in cattle pose a significant global challenge to the beef and dairy industries. Economic losses from liver discounts at slaughter and reduced animal performance drive the need for effective mitigation strategies. Tylosin phosphate supplementation is widely used to reduce LA occurrence, but concerns over antimicrobial overuse emphasize the urgency to explore alternative approaches. Understanding the microbial ecology of LA is crucial to this, and we hypothesized that a reduced timeframe of tylosin delivery would alter LA microbiomes. We conducted 16S rRNA sequencing to assess severe liver abscess bacteriomes in beef cattle supplemented with in-feed tylosin. Our findings revealed that shortening tylosin supplementation did not notably alter microbial communities. Additionally, our findings highlighted the significance of sample processing methods, showing differing communities in bulk purulent material and the capsule-adhered material. Fusobacterium or Bacteroides ASVs dominated LA, alongside probable opportunistic gut pathogens and other microbes. Moreover, we suggest that liver abscess size correlates with microbial community composition. These insights contribute to our understanding of factors impacting liver abscess microbial ecology and will be valuable in identifying antibiotic alternatives. They underscore the importance of exploring varied approaches to address LA while reducing reliance on in-feed antibiotics.
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Affiliation(s)
- Eóin O'Hara
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Ave S, Lethbridge, AB, T1J 4B1, Canada
| | - Rahat Zaheer
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Ave S, Lethbridge, AB, T1J 4B1, Canada
| | - Sara Andrés-Lasheras
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Ave S, Lethbridge, AB, T1J 4B1, Canada
| | - Tim A McAllister
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Ave S, Lethbridge, AB, T1J 4B1, Canada
| | - Robert J Gruninger
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Ave S, Lethbridge, AB, T1J 4B1, Canada
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2
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Kim SW, Jang BK. Toxocara canis and Fasciola hepatica Co-Infection Leading to Hepatic Abscess: A Case Report. J Korean Med Sci 2023; 38:e323. [PMID: 37821089 PMCID: PMC10562180 DOI: 10.3346/jkms.2023.38.e323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/08/2023] [Indexed: 10/13/2023] Open
Abstract
Toxocariasis is a zoonotic disease caused by ingesting eggs from soil contaminated with Toxocara canis and Toxocara cati, commonly found in feces of infected dogs and cats, leading to a range of clinical symptoms including fever, abdominal pain and gastrointestinal manifestations. Fascioliasis is also a zoonotic disease caused by liver flukes Fasciola hepatica and Fasciola gigantica, which can be contracted through consumption of contaminated water or aquatic plants, leading to various clinical features. Here, we report a case of a 39-year-old woman diagnosed with a liver abscess caused by co-infection of T. canis and F. hepatica, as confirmed by serological tests. Although the existence of a pet dog and an experience of eating raw water dropwort are potential clues for diagnosis, it cannot be determined as the source of infection because the source of infection has not been clearly identified. After administrating albendazole and triclabendazole sequentially, the patient showed improvement in blood test and imaging findings. Clinicians should be aware of parasitic co-infection and take appropriate management.
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Affiliation(s)
- Seung Wan Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Byoung Kuk Jang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
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3
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Desalegn H, Tesfaye A, Shume P. Pyogenic Liver Abscess Presenting as an Initial Manifestation of Underlying Hepatocellular Cancer: A Case Report in Ethiopia. Ethiop J Health Sci 2022; 32:665-668. [PMID: 35813683 PMCID: PMC9214730 DOI: 10.4314/ejhs.v32i3.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background An adult patient presented with right abdominal pain and fever to a primary care physician and abdominal ultrasound was performed. With an initial diagnosis of a liver abscess, he was discharged from the hospital after treatment with antibiotics and drainage of the collection. However, the patient had persistent clinical findings on the same site which was later confirmed as Hepatocellular cancer. Case Presentation A 40 years old male patient who was known to have Type 2 Diabetes and Hypertension for 10 years on oral medications referred to the Gastroenterology/Hepatology unit with right upper quadrant pain, loss of appetite, nausea, vomiting of ingested matter, and significant weight loss. On further inquiry, he had been admitted six months back for similar complaints and was managed with antibiotics and drainage of an abscess collection.The multi-phasic abdominal CT scan and raised alphafetoprotein confirmed Hepatocellular Cancer which initially has presented as a pyogenic liver abscess. Conclusion Hepatocellular cancer should be suspected and early diagnosis should be made in individuals presenting with a liver abscess and having risk factors for liver cancer.
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Affiliation(s)
| | - Ayantu Tesfaye
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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4
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Nassif AT, Granella VH, Rucinski T, Cavassin BL, Bassani A, Nassif LT. Laparoscopy treatment of liver abscess secondary to an unusual foreign body (rosemary twig). Autops Case Rep 2021; 11:e2021317. [PMID: 34458185 PMCID: PMC8387063 DOI: 10.4322/acr.2021.317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/02/2021] [Indexed: 12/14/2022] Open
Abstract
A hepatic abscess caused by a swallowed foreign body is a rare and challenging diagnosis. Most patients have nonspecific symptoms, and more than 90% of patients do not remember having swallowed it, which occurred accidentally. In this setting, fish bones, chicken bones, and toothpicks are the most found foreign bodies. We reported the case of a 54-year-old male patient admitted with abdominal pain and intermittent fever. He was diagnosed with liver abscess and treated successfully with antibiotics and a laparoscopic procedure; a rosemary twig was found during the abscess drainage procedure. Furthermore, a literature review of 22 cases of laparoscopic treated liver abscesses associated with a foreign body was made.
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Affiliation(s)
- André Thá Nassif
- Hospital Santa Casa de Curitiba, Department of General Surgery, Curitiba, PR, Brasil
| | - Victor Hugo Granella
- Hospital Santa Casa de Curitiba, Department of General Surgery, Curitiba, PR, Brasil
| | - Tulio Rucinski
- Hospital Santa Casa de Curitiba, Department of General Surgery, Curitiba, PR, Brasil
| | - Bruno Landal Cavassin
- Pontifícia Universidade Católica do Paraná, School of Medicine, Curitiba, PR, Brasil
| | - Alesandra Bassani
- Hospital Santa Casa de Curitiba, Department of General Surgery, Curitiba, PR, Brasil
| | - Lucas Thá Nassif
- Hospital Santa Casa de Curitiba, Department of General Surgery, Curitiba, PR, Brasil
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5
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Ji M, Zhou C, Zhang HY, Zhao LS. [A case of giant caudate lobe liver abscess combined with HIV-1]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:968-9. [PMID: 33256285 DOI: 10.3760/cma.j.cn501113-20200515-00246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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6
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Wang L, Yuan M, Lu Q. Ruptured pyogenic liver abscess with Pneumoperitoneum following pancreaticoduodenectomy. Asian J Surg 2020; 43:1110-1112. [PMID: 32883569 DOI: 10.1016/j.asjsur.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Lei Wang
- Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Soochow University, Changzhou, 213000, China
| | - Maoling Yuan
- Geriatrics, the Third Affiliated Hospital of Soochow University, Changzhou, 213000, China.
| | - Qicheng Lu
- Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Soochow University, Changzhou, 213000, China.
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Affiliation(s)
- Yurong Wang
- Division of General Surgery, Peking University First Hospital, Peking University, Beijing, People's Republic of China
| | - Yisheng Pan
- Division of General Surgery, Peking University First Hospital, Peking University, Beijing, People's Republic of China
| | - Zhengfei Zhou
- Division of General Surgery, Peking University First Hospital, Peking University, Beijing, People's Republic of China.
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8
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Kim JH, Jeong Y, Lee CK, Kim SB, Yoon YK, Sohn JW, Kim MJ. Characteristics of Klebsiella pneumoniae Isolates from Stool Samples of Patients with Liver Abscess Caused by Hypervirulent K. pneumoniae. J Korean Med Sci 2020; 35:e18. [PMID: 31920019 PMCID: PMC6955435 DOI: 10.3346/jkms.2020.35.e18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/12/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Hypervirulent Klebsiella pneumoniae (hvKP) has been the most significant pathogen for liver abscesses in East Asia including the Republic of Korea (ROK). Although gastrointestinal colonization of K. pneumoniae may cross the intestinal barrier to invade the liver, characteristics of gastrointestinal carriage K. pneumoniae of hvKP liver abscess patients in the ROK are not well known. METHODS Characteristics of K. pneumoniae isolated from stool samples and liver aspirate samples of patients with hvKP liver abscess at a tertiary care hospital in the ROK between 2017 and 2018 were evaluated. RESULTS Out of 37 patients with hvKP liver abscess, 11 patients were noted to have K. pneumoniae isolated from stool samples and were enrolled for analysis. The median age was 71 years. For hvKP isolates from the liver aspirate samples, the most common serotype was K1 (72.7%) followed by K2 (27.3%). For K. pneumoniae isolates from the stool sample, the majority was non-K1/K2 serotype (72.7%). Among non-K1/K2 serotype isolates, high variability of sequence type (ST; ST15, ST307, ST37, ST273, ST2622, and ST42) with high rate of presence of extended-spectrum beta-lactamase (100.0%) was noted. The concordance rate of the K. pneumoniae isolates between the liver aspirate samples and the stool samples from the primary hvKP liver abscess was low (27.3%). CONCLUSION This study suggests that significant heterogeneity of K. pneumoniae colonizing intestinal tract of the hvKP liver abscess patients. Further studies involving a larger number of hvKP liver abscess patients with continuing surveillance are needed to define the changing epidemiology and the role of gastrointestinal K. pneumoniae in the hvKP liver abscess patients in the ROK.
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Affiliation(s)
- Jong Hun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoojung Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang Kyu Lee
- Department of Laboratory Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sun Bean Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jang Wook Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Min Ja Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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9
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Abstract
Since the mid 1980s, the prevalence of liver abscess caused by hypervirulent Klebsiella pneumoniae strain has increased in Asia, particularly in Taiwan and Korea. This strain is mostly K1 or K2 serotype, and has hypercapsular and hypermucoid phenotypes. Most infections are community acquired, and patients rarely have a hepatobiliary disease prior to infection. Clinical manifestations are characterized by fever and high C-reactive protein, and metastatic infections, such as septic emboli in the lung and endophthalmitis and meningitis are frequently observed. Antibiotic resistance is rare. Antibiotic treatment and abscess drainage are needed, and early diagnosis and treatment of endophthalmitis is also important.
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Affiliation(s)
- Jae Bum Jun
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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10
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Mateus JE, Silva C, Beirão S, Pimentel J. Hepatic Abscess Induced by Fish Bone Migration: Two Case Reports. ACTA MEDICA PORT 2018; 31:276-279. [PMID: 29916359 DOI: 10.20344/amp.9662] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 02/06/2018] [Indexed: 12/30/2022]
Abstract
Although foreign body ingestion is a common occurrence, perforation and penetration of the gastrointestinal tract is unusual and the development of a hepatic abscess is even more rare. The authors describe two cases of fish bone perforation of the gastrointestinal tract with hepatic perforation and abscess formation, from distinctive age groups and varying presentation, although both developed septic shock. The lack of history of ingestion of foreign bodies, non-specificity of both clinical presentation and complementary examinations all play a role in delaying the diagnosis and therefore in the prognosis itself.
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Affiliation(s)
- José Eduardo Mateus
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Carlos Silva
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Sofia Beirão
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Jorge Pimentel
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
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11
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Pereira A, Petrucci T, Simões MJ. [Klebsiella pneumoniae from K1 and Hypervirulent Clone ST23: First Documented Case in Portugal]. ACTA MEDICA PORT 2017; 30:496-499. [PMID: 28898618 DOI: 10.20344/amp.7705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 03/06/2017] [Indexed: 11/20/2022]
Abstract
The hypervirulent K1 serotype Klebsiella pneumoniae is responsible for a new invasive syndrome, typically associated to hepatic abscesses with extra-hepatic complications. Initially described in Taiwan, it has significantly spread to several Asian countries and more recently to Europe and North America, thus constituting an emerging and global problem. The authors describe a case report of a 64-years-old portuguese caucasian woman without any previous diseases or epidemiological risk factors such as trips or contact with Asian products or population, diagnosed with a pyogenic liver abscess with pleural effusion caused by this hyper-virulent strain. A successful clinical cure was achieved after the etiological identification and treatment with antimicrobial therapy combined with catheter drainage. This is the first identification of hypervirulent Klebsiella pneumonia ST 23 clone in Portugal in the context of an invasive syndrome.
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Affiliation(s)
- Aida Pereira
- Serviço de Doenças Infecciosas. Hospital de Santa Maria. Centro Hospitalar de Lisboa Norte. Lisboa. Portugal
| | - Tiago Petrucci
- Serviço de Medicina I. Hospital de Santa Maria. Centro Hospitalar de Lisboa Norte. Lisboa. Portugal
| | - Maria João Simões
- Unidade Laboratorial Integrada. Departamento de Doenças Infecciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
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12
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Peixoto A, Gonçalves R, Macedo G. Liver Abscess Associated Sepsis Caused by Fish Bone Ingestion. GE Port J Gastroenterol 2016; 23:322-3. [PMID: 28868489 DOI: 10.1016/j.jpge.2016.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 03/13/2016] [Indexed: 11/23/2022]
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13
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Su XF, Li N, Chen XF, Zhang L, Yan M. Incidence and Risk Factors for Liver Abscess After Thermal Ablation of Liver Neoplasm. Hepat Mon 2016; 16:e34588. [PMID: 27642345 PMCID: PMC5018304 DOI: 10.5812/hepatmon.34588] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/16/2016] [Accepted: 04/21/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most frequently used thermal ablation methods for the treatment of liver cancer. Liver abscess is a common and severe complication of thermal ablation treatment. OBJECTIVES The objective of this study was to determine the incidence and risk factors of liver abscess formation after thermal ablation of liver cancer. MATERIALS AND METHODS The clinical data of 423 patients who underwent 691 thermal ablation procedures for liver cancer were collected in order to retrospectively analyze the basic characteristics, incidence, and risk factors associated with liver abscess formation. Patients with multiple risk factors for liver abscess formation were enrolled in a risk factor group, and patients with no risk factors were enrolled in a control group. The chi-square test and multiple logistic regression analysis were used to analyze the relationship between the occurrence of liver abscesses and potential risk factors. RESULTS Two hundred and eight patients underwent 385 RFA procedures, and 185 patients underwent 306 MWA procedures. The total incidence of liver abscesses was 1.7%, while the rates in the RFA group (1.8%) and MWA groups (1.6%) were similar (P > 0.05). The rates of liver abscesses in patients who had child-pugh class B and class C cirrhosis (P = 0.0486), biliary tract disease (P = 0.0305), diabetes mellitus (P = 0.0344), and porta hepatis tumors (P = 0.0123) were 4.0%, 6.7%, 6.5%, and 13.0%, respectively. There was a statistically significant difference between these four groups and the control group (all P < 0.05). The incidence of liver abscesses in the combined ablation and percutaneous ethanol injection (PEI) group (P = 0.0026) was significantly lower than that of the ablation group (P < 0.05). CONCLUSIONS The incidence of liver abscesses after liver cancer thermal ablation is low. Child-Pugh Class B and Class C cirrhosis, biliary tract disease, diabetes mellitus, and porta hepatis tumors are four significant risk factors. Combined ablation and PEI reduces the rate of liver abscesses.
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Affiliation(s)
- Xiu-Feng Su
- Department of Geriatric Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
- Department of Oncology, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China
| | - Na Li
- Department of Rheumatology, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China
| | - Xu-Fang Chen
- Department of Oncology, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China
| | - Lei Zhang
- Department of Infectious Diseases, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China
| | - Ming Yan
- Department of Geriatric Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
- Corresponding Author: Ming Yan, Department of Geriatric Gastroenterology, Qilu Hospital, Shandong University, Jinan, China. E-mail:
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Hanafiah M, Yahya A, Zuhdi Z, Yaacob Y. A case of an undifferentiated embryonal sarcoma of the liver mimicking a liver abscess. Sultan Qaboos Univ Med J 2014; 14:e578-e581. [PMID: 25364566 PMCID: PMC4205075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 04/02/2014] [Accepted: 05/15/2014] [Indexed: 06/04/2023] Open
Abstract
An undifferentiated embryonal sarcoma of the liver is a rare malignant tumour. We highlight the diagnostic dilemma and differential diagnosis of a case involving a large cystic liver lesion in a young adult. A 20-year-old man presented with a large liver lesion to the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia, in February 2012. The initial clinico-radiological presentations were suggestive of a liver abscess. A total tumour resection was performed and the final histopathological results of the resected specimen indicated an undifferentiated embryonal sarcoma of the liver. The ultrasound and computed tomographic images of the tumour were reviewed and found to be contradictory in appearance, as the tumour seemed predominantly solid in the ultrasound image and predominantly cystic in the computed tomographic image. Familiarisation with the imaging appearance of this tumour and a high index of suspicion is therefore crucial in making a successful diagnosis.
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Affiliation(s)
| | - Azyani Yahya
- Departments of Pathology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Zamri Zuhdi
- Surgery, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Yazmin Yaacob
- Radiology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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15
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Baptista MA, Lo DS, Hein N, Hirose M, Yoshioka CRM, Ragazzi SLB, Gilio AE, Ferronato AE. Cat-scratch disease presenting as multiple hepatic lesions: case report and literature review. Autops Case Rep 2014; 4:43-48. [PMID: 28580326 PMCID: PMC5448301 DOI: 10.4322/acr.2014.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/10/2014] [Indexed: 11/23/2022]
Abstract
Although infectious diseases are the most prevalent cause of fevers of unknown origin (FUO), this diagnosis remains challenging in some pediatric patients. Imaging exams, such as computed tomography (CT) are frequently required during the diagnostic processes. The presence of multiple hypoattenuating scattered images throughout the liver associated with the history of cohabitation with cats should raise the suspicion of the diagnosis of cat-scratch disease (CSD), although the main etiologic agent of liver abscesses in childhood is Staphylococcus aureus. Differential diagnosis by clinical and epidemiological data with Bartonella henselae is often advisable. The authors report the case of a boy aged 2 years and 9 months with 16-day history of daily fever accompanied by intermittent abdominal pain. Physical examination was unremarkable. Abdominal ultrasound performed in the initial work up was unrevealing, but an abdominal CT that was performed afterwards disclosed multiple hypoattenuating hepatic images compatible with the diagnosis of micro abscesses. Initial antibiotic regimen included cefotaxime, metronidazole, and oxacillin. Due to the epidemiology of close contact with kittens, diagnosis of CSD was considered and confirmed by serologic tests. Therefore, the initial antibiotics were replaced by clarithromycin orally for 14 days followed by fever defervescence and clinical improvement. The authors call attention to this uncommon diagnosis in a child presenting with FUO and multiple hepatic images suggestive of micro abscesses.
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Affiliation(s)
- Mariana Andrade Baptista
- Department of Pediatrics - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Denise Swei Lo
- Department of Pediatrics - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Noely Hein
- Department of Pediatrics - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Maki Hirose
- Department of Pediatrics - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | - Selma Lopes Betta Ragazzi
- Department of Pediatrics - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Alfredo Elias Gilio
- Department of Pediatrics - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil.,Department of Pediatrics - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Angela Esposito Ferronato
- Department of Pediatrics - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
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16
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Choi EJ, Lee S, Jeong DW, Cho YH, Lee SJ, Lee JG, Kim YJ, Yi YH, Lim JY. Pyogenic liver abscess following acupuncture and moxibustion treatment. Korean J Fam Med 2013; 34:364-8. [PMID: 24106589 PMCID: PMC3791344 DOI: 10.4082/kjfm.2013.34.5.364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 08/21/2013] [Indexed: 11/22/2022] Open
Abstract
Acupuncture treatment is generally regarded as a relatively safe procedure. However, most procedures have some complications and acupuncture treatment is no exception. Reported complications of acupuncture treatment were mostly mild or temporary symptoms, but certain severe adverse effects were also observed. We report here for the first time a case of liver abscess following acupuncture and moxibustion treatment.
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Affiliation(s)
- Eun Jung Choi
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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17
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Kwon JM, Jung HL, Shim JW, Kim DS, Shim JY, Park MS. Klebsiella pneumoniae liver abscess in an immunocompetent child. Korean J Pediatr 2013; 56:407-10. [PMID: 24223603 PMCID: PMC3819678 DOI: 10.3345/kjp.2013.56.9.407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 12/28/2012] [Accepted: 01/29/2013] [Indexed: 11/27/2022]
Abstract
Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.
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Affiliation(s)
- Jang-Mi Kwon
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim HS, Park DW, Youn YK, Jo YM, Kim JY, Song JY, Sohn JW, Cheong HJ, Kim WJ, Kim MJ, Choi WS. Liver abscess and empyema due to Lactococcus lactis cremoris. J Korean Med Sci 2010; 25:1669-71. [PMID: 21060760 PMCID: PMC2967008 DOI: 10.3346/jkms.2010.25.11.1669] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Accepted: 02/09/2010] [Indexed: 11/20/2022] Open
Abstract
Lactococcus lactis cremoris infections are very rare in humans. We experienced liver abscess and empyema due to L. lactis cremoris in an immunocompetent adult. A 42-yr-old man was admitted with fever and abdominal pain. Abdominal computed tomography (CT) revealed a liver abscess and chest CT showed loculated pleural effusion consistent with empyema. L. lactis cremoris was isolated from culture of the abscess material and blood. The patient was treated with pus drainage from liver abscess, video-assisted thoracoscopic decortications for empyema, and antibiotics including cefotaxime and levofloxacin. The patient was completely recovered with the treatment. To our knowledge, this is the first report of a L. lactis cremoris infection in Korea.
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Affiliation(s)
- Hye Sook Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dae Won Park
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kyoung Youn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yu Mi Jo
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jeong Yeon Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jang-Wook Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Min Ja Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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