Dongmo Miaffo DOE, Chafaaoui H, Assan BR, Mantho P, Ntankeu PP.
Neonatal pyogenic liver abscess following omphalitis: A case report.
Int J Surg Case Rep 2023;
110:108711. [PMID:
37634436 PMCID:
PMC10509795 DOI:
10.1016/j.ijscr.2023.108711]
[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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE
Liver abscesses in neonates are rare. Omphalitis is a very rare cause. We report a case of a voluminous neonatal pyogenic liver abscess following omphalitis, successfully managed in our institution.
CASE PRESENTATION
A 21-day-old full-term female newborn was brought to our institution for progressive febrile swelling of the right hypochondrium. The parents reported umbilical suppuration. Clinical examination confirmed the presence of a mass extending from the epigastric region to the right hypochondrium in a febrile baby with no other abnormalities. Laboratory investigations revealed an elevated C-reactive protein level (64 mg/dl) and hyperleukocytosis (20,800/mm3) with neutrophil predominance and normochromic microcytic anemia (hemoglobin 8.2 g/dl). Her first abdominal ultrasound was interpreted as a cyst of the common bile duct. Triple antibiotic therapy with cephalosporin, ampicillin and gentamycin was started, but unsuccessful. Abdominal ultrasound was repeated, revealing a hepatic abscess in segment 8, with a volume of approximately 17 ml. Percutaneous echo-guided drainage was performed and antibiotic therapy was readjusted after identification of the germ (Staphylococcus aureus) with good outcome. The baby was discharged two weeks later. At one month follow-up, the baby was completely asymptomatic.
CLINICAL DISCUSSION AND CONCLUSION
As neonatal liver abscesses are unusual, they can lead to misdiagnosis. Omphalitis is a very rare cause. Treatment by percutaneous echo-guided drainage is simple and effective.
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