Hepatic Clostridium Perfringens Abscess Formation after Radiofrequency Ablation Therapy for Hepatocellular Carcinoma: Report of a Rare Case

Liver abscess formation is one of the major complications following radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). <i>Clostridium perfringens</i> is a rare but fatal (mortality rate: 70–100%) organism that could lead to severe sepsis. We presented a case where a 63-year-old woman with diabetes mellitus, hypertension, chronic hepatitis B-related cirrhosis in Child-Pugh class A and HCC with initial TNM stage II who had undergone 2 sessions of transarterial chemoembolization. RFA was performed for 4 small HCC due to poor effect of previous transarterial chemoembolization. However, all 4 treated tumors developed liver abscesses presenting with septic shock within 1 day. Aspirated abscesses and blood culture both yielded <i>C. perfringens</i> infection. After intensive care, optimal intravenous antibiotic, and abscesses aspiration, the patient recovered successfully. All tumors achieved complete response during the follow-up period without local recurrence. The clinical presentations and risk factors of <i>C. perfringens</i>-related liver abscess after RFA will be discussed in this manuscript.