Unusual Liver Mass in an Immunocompetent Adult: A Case Report and Literature Review.
hepatic abscess
methicillin-resistant staphylococcus aureus (mrsa)
pyogenic liver abscess
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
22 Mar 2020
22 Mar 2020
Historique:
entrez:
25
4
2020
pubmed:
25
4
2020
medline:
25
4
2020
Statut:
epublish
Résumé
A hepatic abscess is a rare disease, especially in developed countries, and usually results from microbial contamination of liver parenchyma via an arterial or portal system or from a direct spread by contiguity. Pyogenic liver abscesses (PLA) are polymicrobial with Staphylococcus aureus accounting for less than 10% of the cases and methicillin-resistant Staphylococcus aureus (MRSA) accounting for even fewer. Colonic and hepatobiliary pathologies are often associated with reported MRSA abscesses. We report a case of MRSA bacteremia and liver abscess in an immunocompetent patient with no significant risk factors. Our patient presented with fever and abdominal pain of four days' duration. Laboratory studies revealed neutrophilic leukocytosis, elevated creatinine, c-reactive protein, and transaminitis. Blood culture was positive for MRSA. Computed tomography (CT) of the abdomen showed multiple areas of hypodensities over the left hepatic lobe that placed malignancy and abscess into the main differentials. A liver biopsy was consistent with liver abscess. Drainage was performed after a month of treatment with intravenous (IV) daptomycin and microbial analysis of the abscess was negative. Our case signifies the association of liver abscess and MRSA bacteremia in a patient with no significant risk factors and highlights the importance of prompt antibiotic treatment as first-line therapy.
Identifiants
pubmed: 32328373
doi: 10.7759/cureus.7361
pmc: PMC7174860
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e7361Informations de copyright
Copyright © 2020, Dessie et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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