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



Abstract

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.

Keywords: Liver abscess pediatric anaemia conservative.

References

  1. Dutta A, Bandyopadhyay S. Management of liver abscess. Medicine. 2012;22:469-75.
  2. Sharma MP, Kumar A. Liver abscess in children. Indian Journal of Pediatrics. 2006;73(9):813-7
  3. Mishra K, Basu S, Roychoudhury S, Kumar P. Liver abscess in children: an overview. World J Pediatr. 2010;6(3):210-6.
  4. Bisanto J, Firman K. Abses Hati pada Anak. Sari Pediatri. 2016;7(1):50-6.
  5. Lübbert C, Wiegand J, Karlas T. Therapy of liver abscesses. Viszeralmedizin. 2014;30(5):334-41.
  6. Liu Y, Wang JY, Jiang W. An Increasing Prominent Disease of Klebsiella pneumoniae Liver Abscess: Etiology, Diagnosis, And Treatment. Gastroenterol Res Pract. 2013;2013:258514.
  7. Simeunovic E, Arnold M, Sidler D, Moore SW. Liver abscess in neonates. Pediatr Surg Int. 2009;25(2):153-6.
  8. Waghmare M, Shah H, Tiwari C, Khedkar K, Gandhi S. Management of Liver Abscess in Children: Our Experience. Euroasian J Hepatogastroenterol. 2017;7(1):23-26
  9. Salahi R, Dehghani SM, Salahi H, Bahador A, Abbasy HR, Salahi F. Liver abscess in children: a 10-year single centre experience. Saudi J Gastroenterol. 2011;17(3):199-202.
  10. Lin AC, Yeh DY, Hsu YH, Wu CC, Chang H, Jang TN, et al. Diagnosis of pyogenic liver abscess by abdominal ultrasonography in the emergency department. Emerg Med J. 2009;26(4):273-5.
  11. Popescu A, Moga T, Sporea I, Sandulescu L, Sirli R, Danila M, et al. Contrast-Enhanced Ultrasound in the Diagnostic of Liver Abscesses. A Prospective Multicenter Experience. Ultrasound in Medicine and Biology. 2017;43(Suppl_1):S51.
  12. Bamberger DM. Outcome of medical treatment of bacterial abscesses without therapeutic drainage: review of cases reported in the literature. Clin Infect Dis. 1996;23(3):592-603.
  13. Heneghan HM, Healy NA, Martin ST, Ryan RS, Nolan N, Traynor O, et al. Modern management of pyogenic hepatic abscess: a case series and review of the literature. BMC Res Notes. 2011;4(1):80.
  14. Rahimian J, Wilson T, Oram V, Holzman RS. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infectious Dis. 2004;39(11):1654-9.
  15. Liu Y, Wang JY, Jiang W. An increasing prominent disease of Klebsiella pneumoniae liver abscess: etiology, diagnosis, and treatment. Gastroenterol Res Pract. 2013; 2013:258514
  16. Stanley SL Jr. Amoebiasis. Lancet. 2003;361(9362):1025-34.
  17. Weiss G, Goodnough LT. Anemia of chronic disease. N Eng J Med. 2005;352(10):1011-23.
  18. Chaubey D, Pandey A, Kumar P, Gupta A, Rawat J, Wakhlu A, et al. Liver abscess in children: challenges in management. International Surgery Journal. 2016;4(1):107-10.
  19. Ba ID, Ba A, Faye PM, Diouf FN, Sagna A, Thiongane A, et al. Particularities of liver abscesses in children in Senegal: Description of a series of 26 cases. Arch Pediatr. 2016;23(5):491-6.
  20. Sánchez-Aguilar M, Moran-Mendoza O, Herrera-Hernandez MF, Hernández-Sierra JF, Mandeville PB, Tapia-Perez JH, et al. Prognostic indications of the failure to treat amoebic liver abscesses. Pathog Glob Health. 2012;106(4):232-7.
  21. Tanyuksel M, Tachibana H, Petri WA. Amebiasis, an emerging disease. In: Emerging Infections American Society of Microbiology. 2001;5:197-212.
  22. Tanyuksel M, Petri WA Jr. Laboratory diagnosis of amebiasis. Clin Microbiol Rev. 2003;16(4):713-29.
  23. Otto MP, Gérôme P, Rapp C, Pavic M, Vitry T, Crevon L, et al. Falseâ€Negative Serologies in amebic liver abscess: report of two cases. J Travel Med. 2013;20(2):131-3.
  24. Alexopoulou A, Dimopoulou H, Soultati A, Panetsos G, Dourakis SP. Factor related to complications and mortality in pyogenic liver abscesses. Annals of Gastroenterology. 2010;23(4):296-301.
  25. Bari S, Sheikh KA, Malik AA, Wani RA, Naqash SH.. percutaneous aspiration versus open drainage of liver abscess in children. Pediatr Surg Int. 2007;23(1):69-74.

How to Cite

Widnyani, I. G. I. A., Karyana, I. P. G., Putra, I. G. N. S., & Nesa, N. M. (2020). A large-liver abscess with severe anaemia in 6 years-old patient: a case report. Intisari Sains Medis, 11(1), 1–6. https://doi.org/10.15562/ism.v11i1.508
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I Gusti Istri Agung Widnyani
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I Putu Gede Karyana
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I Gusti Ngurah Sanjaya Putra
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Nyoman Metriani Nesa
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