Case Report

A large-liver abscess with severe anaemia in 6 years-old patient: a case report

I Gusti Istri Agung Widnyani , I Putu Gede Karyana, I Gusti Ngurah Sanjaya Putra, Nyoman Metriani Nesa

I Gusti Istri Agung Widnyani
Department of Child Health, Medical School, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia. Email: dr.agungwidnyani@gmail.com

I Putu Gede Karyana
Department of Child Health, Medical School, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia

I Gusti Ngurah Sanjaya Putra
Department of Child Health, Medical School, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia

Nyoman Metriani Nesa
Department of Child Health, Medical School, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia
Online First: February 29, 2020 | Cite this Article
Widnyani, I., Karyana, I., Putra, I., Nesa, N. 2020. A large-liver abscess with severe anaemia in 6 years-old patient: a case report. Intisari Sains Medis 11(1): 1-6. DOI:10.15562/ism.v11i1.508


Background: Liver abscess are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amoebic. A pyogenic liver abscess (PLA) is a potentially lethal condition. This study aims to describe the signs, symptoms, and prognosis of pyogenic liver abscess in children with severe anaemia.

Case Description: Six years old boy complained about abdominal pain for 4 months before admitted to the hospital. The abdomen began to stiff 23 days before. Since 4 weeks, there was several episodes of fevers, more than 4 times but not more than 3 days, relieved by antipyretic. Every fever followed by a stomachache. His parents said he looked paler than before and his activities decreased, was sleepy and irritable. In physical examination, we found the patient looked anaemic, with a distended abdomen with hepatomegaly. Routine CBC revealed: WBC was 16.99, Hemoglobin was 5.45g/dL platelet was 796.20, iron parameters was: iron serum: 11.27 ug/dL (normal: 50-120 ug/dL) TIBC: 180 ug/dL(normal 225-450 ug/dL). A liver abscess 4.5 cm x 5.1 cm with liquefaction was obtained by ultrasound and confirmed by abdomen MSCT with contrast 4,4 x 4,3 x 6,1 cm. The patient family refused abscess draining surgery, so only conservative therapy by antibiotics was given and further followed up in polyclinic. Nine-month after therapy, follow up by ultrasound was normal.

Conclusion: The sign and symptom of pyogenic LA were non-specific; abdomen MSCT confirmed the diagnosis with contrast. The prognosis was good.

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