Unlabelled: In this case, a 76-year-old female presented with 3-4 days of fever with no other localizing signs. Notably, she had had an untreated bacteraemia approximately 8 weeks prior to admission. She underwent abdominal imaging which demonstrated a liver abscess and had percutaneous drainage of the same. Blood and pus cultures both grew , which is an unusual organism to be associated with a liver abscess, especially in an immunocompetent host with no risk factors for this condition. Interestingly, this patient did not have any history of dental work, instrumentation, liver function test (LFT) abnormalities and no extrahepatic source for the abscess. This case highlights the importance of having a high index of clinical suspicion for an occult source of infection and emphasizes the importance of following up on cultures even after discharge of a patient, since anaerobic infections such as those caused by can have a largely indolent course.
Learning Points: Fever of unknown aetiology with prior bacteraemia merits a thorough work-up for occult sources such as a localized abscess or malignancy, which can cause bacterial translocation.Fusobacterium and other anaerobic infectious agents should be considered in the context of an indolent disease course since they are slow-growing in cultures, and also, if the patient has risk factors such as immunosuppression, diabetes, poor oral hygiene and so on.It is important to have systems in place in hospitals to ensure follow-up for patients who may have a positive culture after discharge from hospital to confirm that the infection is adequately addressed.
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http://dx.doi.org/10.12890/2020_001741 | DOI Listing |
Am J Case Rep
January 2025
Department of Surgery, Cantonal Hospital of Fribourg (HFR), Villars-sur-Glâne, Switzerland.
BACKGROUND Crohn disease is a chronic inflammatory bowel disease known for causing fistulous tracts, abscesses, and bowel perforation. Enterohepatic fistulas, a rare but significant complication, are scarcely reported. This article presents the case of a hepatic abscess due to an enterohepatic fistula in a patient with long-term Crohn disease and reviews the existing literature on this phenomenon.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. China.
Rationale: Carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections are a severe complication resulting from granulocyte deficiency following chemotherapy for hematologic malignancies and have a high mortality rate. However, reports of disseminated organ infections secondary to bloodstream infections are rare.
Patient Concerns And Diagnoses: We report 2 cases of patients with acute lymphoblastic leukemia who both developed CRKP bloodstream infections during the granulocyte deficiency stage following chemotherapy, with 1 case of secondary bacterial liver abscess and 1 case of secondary septic arthritis.
ACG Case Rep J
January 2025
Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Liver transplant may be necessary to manage infectious complications from severe structural biliary disease. In this report, we describe a 71-year-old woman with history of coil-embolized hepatic artery pseudoaneurysm who subsequently developed biliary obstruction resulting from coil erosion into the common hepatic duct. Resultant complications included recurrent cholangitis, bacteremia, and numerous hepatic abscesses.
View Article and Find Full Text PDFNat Rev Dis Primers
January 2025
European Reference Network for Rare Multisystemic Vascular Disease (VASCERN), HHT Rare Disease Working Group, Paris, France.
Hereditary haemorrhagic telangiectasia (HHT) is a vascular dysplasia inherited as an autosomal dominant trait and caused by loss-of-function pathogenic variants in genes encoding proteins of the BMP signalling pathway. Up to 90% of disease-causal variants are observed in ENG and ACVRL1, with SMAD4 and GDF2 less frequently responsible for HHT. In adults, the most frequent HHT manifestations relate to iron deficiency and anaemia owing to recurrent epistaxis (nosebleeds) or bleeding from gastrointestinal telangiectases.
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