An unusual case of sepsis: liver abscess masquerading as pneumonia

2017 ◽  
Vol 16 (2) ◽  
pp. 92-95
Author(s):  
Mohandas Kozhippally ◽  
◽  
Subash Sivaraman ◽  
Keyword(s):  
Liver Abscess ◽  
Unusual Case ◽  
Previous History ◽  
Pyogenic Liver Abscess ◽  
Complete Recovery ◽  
Liver Function Tests ◽  
Community Acquired Pneumonia ◽  
Image Guided ◽  
Intravenous Antibiotics ◽  
History Of

A 63-year-old woman presented with fever, tachycardia and tachypnoea, with right sided chest and hypochondrial pain. Chest radiograph showed right basal consolidation and she was treated for community acquired pneumonia with intravenous antibiotics. Subsequent clinical deterioration in presence of a previous history of complicated diverticulitis, persistent right hypochondrial pain and deranged liver function tests prompted further investigations that confirmed presence of a large pyogenic liver abscess. Following appropriate antibiotic treatment and image guided drainage of the abscess, the patient made a complete recovery. This case illustrates the importance of considering a subdiaphragmatic source of sepsis even in the presence of chest radiographic abnormalities, when a patient fails to respond to initial treatment for pneumonia.

Pyogenic Liver Abscess in Normal Children With Fever of Unknown Origin

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 614-616 ◽  
Author(s):  
Sheldon L. Kaplan ◽  
Ralph D. Feigin
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Pyogenic Liver Abscess ◽  
Liver Function Tests ◽  
Blood Cultures ◽  
Normal Children ◽  
The Past ◽  
Liver Abscesses

Solitary pyogenic hepatic abscesses were identified as the cause of fever, abdominal pain, and hepatomegaly in two otherwise normal children who were seen at St. Louis Children's Hospital during the past year. Liver function tests were normal and blood cultures were negative in both patients. These cases illustrate that pyogenic liver abscess may occur in normal children and should be considered whenever fever of unknown origin is associated with abdominal complaints. Only in this way can we hope to improve upon the results cited previously, namely that the majority of liver abscesses remain undiagnosed during life.

Primary lung abscess due to multidrug-resistant Klebsiella pneumoniae

2021 ◽  
Vol 14 (9) ◽  
pp. e244759
Author(s):  
Mascarenhas Chrystle ◽  
Acharya Vishak ◽  
Kamath Sindhu ◽  
Mendonca Jane
Keyword(s):  
Klebsiella Pneumoniae ◽  
Unusual Case ◽  
Early Recognition ◽  
Multidrug Resistant ◽  
Community Acquired Pneumonia ◽  
Lung Abscess ◽  
Drug Resistant ◽  
Management Guidelines ◽  
History Of

Primary lung abscess as a complication of necrotising community-acquired pneumonia due to multidrug-resistant (MDR) Klebsiella pneumoniae is rare. A 63-year-old man with a medical history of type 2 diabetes mellitus and chronic kidney disease was diagnosed with lung abscess due to MDR Klebsiella pneumoniae, a rare organism as a causative agent for community-acquired pneumonia. This unusual case revealed therapeutic challenges faced owing to factors such as drug-resistant pathogen, longer duration of antibiotics required for lung abscess and the chronic kidney status of the patient limiting the dosage of antibiotics. The clinical nuggets discussed in this case might pave the way in the future for management guidelines to be formulated in optimising the selection and duration of therapy for lung abscesses with MDR aetiology and in early recognition of this rare but dreaded entity.

An unusual case of dysphagia

2018 ◽  
Vol 17 (3) ◽  
pp. 154-155
Author(s):  
Adam Williamson ◽  
◽  
Christopher Kelly ◽  
Keyword(s):  
Unusual Case ◽  
Previous History ◽  
Upper Respiratory Tract ◽  
Medical Unit ◽  
Solid Foods ◽  
Acute Medical Unit ◽  
History Of ◽  
Upper Respiratory ◽  
Ventriculo Peritoneal Shunt

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of neck or back pain and her pain was not controlled with simple analgesia. She also complained of new odynophagia and high dysphagia, particularly to solid foods. There was no history of upper respiratory tract infection.

Sudden hearing loss in intralabyrinthine haemorrhage in a child

2004 ◽  
Vol 118 (6) ◽  
pp. 450-452 ◽  
Author(s):  
Chul Ho Jang ◽  
Young Ho Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Unusual Case ◽  
Previous History ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Bleeding Disorders ◽  
Resonance Imaging ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

This paper reports an unusual case in which aseptic meningitis presented with sudden sensorineural hearing loss (SSNHL) associated with intralabyrinthine haemorrhage (ILH). A seven-year-old girl presented with sudden right-sided hearing loss with dizziness. She did not have a previous history of bleeding disorders. This child was assessed using audiograms and magnetic resonance imaging (MRI). The patient's hearing loss was irreversible. Steroid therapy was not effective. SSNHL associated with ILH can be one of the negative prognostic factors in children.

scholarly journals Intracranial Hemorrhage Secondary to a Delayed Cerebral Pseudoaneurysm Rupture 18 Years after Cranial Trauma

2019 ◽  
Vol 11 (3) ◽  
pp. 325-329
Author(s):  
Mikel Terceño ◽  
Sebastià Remollo ◽  
Yolanda Silva ◽  
Saima Bashir ◽  
Carlos Castaño ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Previous History ◽  
Complete Recovery ◽  
Good Clinical Outcome ◽  
Intracranial Hematoma ◽  
Cranial Trauma ◽  
History Of ◽  
Etiological Study

We report the case of a 38-year-old male with a previous history of severe cranial trauma and subsequent large subdural and subarachnoid hemorrhage on whom an emergent hematoma evacuation was performed with a good outcome and follow-up. Despite a good clinical evolution, the patient experienced a further intracranial hematoma 18 years after the trauma, with severe aphasia and mild right hemiparesis. After complete etiological study, two cranial pseudoaneurysms were observed in the cerebral angiography. Endovascular treatment was successfully completed, achieving full embolization without complications. No rebleeding was detected during follow-up. The patient had a good clinical outcome at 3 months and achieved complete recovery. Cranial pseudoaneurysm rupture is a rare cause of intracerebral hemorrhage, especially if the trauma occurs years before the bleeding.

scholarly journals Correlation between abscess size and liver function tests in cases of liver abscess

2017 ◽  
Vol 5 (8) ◽  
pp. 3340
Author(s):  
Vineet Jain ◽  
Smita Manjavkar ◽  
Divya Rajput ◽  
Abhinav Jain ◽  
. Jyotsana ◽  
...  
Keyword(s):  
Liver Function ◽  
Serum Albumin ◽  
Liver Abscess ◽  
Liver Enzymes ◽  
Major Change ◽  
Pyogenic Liver Abscess ◽  
Liver Function Tests ◽  
Amoebic Liver Abscess ◽  
Male Preponderance ◽  
Risk Patients

Background: Liver abscess has shown a major change in demographics, etiology, diagnosis, and treatment over the past 100 years. The modern diagnostics like ultrasound and computed tomography to locate and drain the abscess have reduced the mortality to 2-12%. However, due to the complications of liver abscess especially the amebic ones the morbidity is still high. This study aims to study the correlation of various LFT parameters with abscess volume for early detection of high risk patients and early treatment thus reducing morbidity.Methods: The study was conducted over a period of 6 months on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. The data was recorded and compiled in excel sheets and analyzed using correlation coefficient (R) method.Results: The mean age of the patients was 41.2 years with male preponderance. Amoebic liver abscess (88%) was predominant over pyogenic liver abscess (12%). Alcoholism (48%), smoking (42%) and diabetes mellitus (18%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 88% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. Complications seen were pleural effusion (10%) and ascites (4%). On analysis, liver abscess size is significantly positively correlated with INR, ALP, liver enzymes, and negatively correlated with serum albumin level.Conclusions: Liver abscess size was found to be positively correlated with INR and alkaline phosphatase (ALP), liver enzymes (SGOT, SGPT) and negatively correlated with serum albumin levels. There was no correlation of abscess size and bilirubin levels. Hence, LFT can be used to estimate the liver abscess size and predict the severity and prognosis of patient.

scholarly journals Therapeutic Success in Amoebic and Pyogenic Liver Abscesses

2021 ◽  
Vol 3 (1) ◽  
pp. 1-10
Author(s):  
Azhari Gani ◽  
Malahayati
Keyword(s):  
Clinical Improvement ◽  
Liver Abscess ◽  
Bed Rest ◽  
Pyogenic Liver Abscess ◽  
Therapeutic Success ◽  
The Past ◽  
History Of ◽  
Surgical Sutures ◽  
Surgery Department

A 52 year old male patient presented with complaints of upper right abdominal pain since 1 month ago, worsening in the last 1 day. Fever has been complained of since 1 month ago, fever fluctuates indefinitely, comes down with fever-reducing drugs, complained of weakness. There is nausea and vomiting, vomiting 1-2 times per day, black vomit like coffee is not there. Complained about weight loss. BAK is like strong tea. Liquid defecation has been complained of since 5 weeks ago, initially liquid defecation was accompanied by mucus and blood with a frequency of 3-4 times per day for 3 days, at that time the patient went to the health center and complaints were reduced and now liquid CHAPTER 1-2 times a day is yellow, liquid, no mucus, no blood for the past 1 month. The patient is an agricultural instructor with his daily activities going down to the farm. History. History of diabetes mellitus denied. Patients diagnosed with multiple pyogenic liver abscess were treated at RSUDZA and received bed rest therapy, 1800 kcal / day soft food diet, IVFD NaCl 0.9% 20 drops per macro minute, metronidazole drip 500 mg every 8 hours, ciprofloxacin 2x 500 mg, intravenously paracetamol 1 gram every 8 hours. The patient was treated for 17 days, on the 10th day of hospitalization the patient was performed a laparotomy and multiple incisions of the liver abscess, purulent abscess fluid mixed with blood. The abscess fluid was cultured as a result of Entamoeba Colli, and metronidazole antibiotic therapy was continued. During treatment, the patient experienced clinical improvement, the patient was opened surgical sutures on the 10th and 15th day after laparotomy, the surgical wound improved, the patient experienced clinical improvement, currently the patient is still a control at the Internal Medicine and Surgery Department at Cut Nyak Dhien Meulaboh Hospital.

scholarly journals An unusual case of bilateral hydroureter: solved by a gynaecologist

2018 ◽  
Vol 7 (3) ◽  
pp. 1273
Author(s):  
Nagendra Sardeshpande ◽  
Jainesh Doctor
Keyword(s):  
Unusual Case ◽  
Previous History ◽  
Pelvic Anatomy ◽  
Ureteric Stenting ◽  
History Of ◽  
Unmarried Girl

A 26-year unmarried girl presented with severe dysmenorrhoea and hesitancy of micturition during menses since, 2 years. She had history of regular menstruation. On IVP and ultrasound there was presence bilateral hydroureter and hydronephrosis. She had previous history of cystoscopy with bilateral ureteroscopy done for the same. Bilateral ureteric stenting for a period of 3 months was done 1 year earlier, however it failed to resolve the hydroureter. A MRI was done, which showed hydroureter with surrounding endometriotic nodule. Laparoscopy was done, and ureteral shaving was performed. Postoperative IVP showed normal ureteral and renal pelvic anatomy. Patient is presently on Dienogest and is asymptomatic.

scholarly journals Pyogenic Liver Abscess, Bacteremia, and Meningitis with HypermucoviscousKlebsiella pneumoniae: An Unusual Case Report in a Human T-Cell Lymphotropic Virus Positive Patient of Caribbean Origin in the United States

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Gargi Patel ◽  
Neha Shah ◽  
Roopali Sharma
Keyword(s):  
Liver Abscess ◽  
Unusual Case ◽  
Pyogenic Liver Abscess ◽  
The United States ◽  
Causative Organism ◽  
Unique Form ◽  
E Coli ◽  
First Case ◽  
Human T Cell ◽  
Unusual Case Report

Pyogenic liver abscess (PLA) is a potentially fatal disease.Klebsiella pneumoniae(K. pneumoniae) has replacedEscherichia coli(E. coli) as the predominant causative organism for pyogenic liver abscess. Over the years a unique form of community-acquired invasiveK. pneumoniaeinfection of the liver has been well described in Southeast Asia. This has recently been linked to a virulent hypermucoviscousK. pneumoniaephenotype and to a specific genotype,rmpApositive. To our knowledge, we report the first case of PLA with bacteremia and meningitis in a Guyanese patient with the presence ofrmpA-positiveK. pneumoniaewith laboratory evidence in North America.

scholarly journals Cryptogenic Pyogenic Liver Abscess Due to Fusobacterium nucleatum in an Immunocompetent Patient

2020 ◽  
Author(s):  
Neeraja Swaminathan ◽  
Francisco Aguilar
Keyword(s):  
Liver Abscess ◽  
Fusobacterium Nucleatum ◽  
Pyogenic Liver Abscess ◽  
Immunocompetent Patient ◽  
Immunocompetent Host ◽  
Source Of Infection ◽  
Function Test ◽  
History Of ◽  
Anaerobic Infections ◽  
Dental Work

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 Fusobacterium 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 Fusobacterium nucleatum, 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 Fusobacterium can have a largely indolent course.

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