Absceso hepático piógeno en pediatría: experiencia en un centro pediátrico de referencia

Carballo, Carolina; Cazes, Claudia; Matsuda, Mariana; Praino, M.L.; Rivas, N.; López, Emiliano

doi:10.4067/s0716-10182017000200005

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…CGD) similar to our current case [10]. Of the approximately 20 other cases documented, most were from Brazil and Argentina with a few cases of neonatal hepatic abscesses [9][10][11][12], predominantly amoebic in etiology.…”

Section: Discussionsupporting

confidence: 81%

Fever of Unknown Origin: A Case Report of Hepatic Phlegmon in an Immunocompetent Patient

Pruitt,

Filipek,

Williford

et al. 2024

Cureus

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Methicillin-resistant Staphylococcus aureus (MRSA) hepatic phlegmon is a rare cause of fever of unknown origin (FUO) in an immunocompetent patient from a high-income country (HIC). MRSA hepatic phlegmon is typically linked to protein malnutrition and chronic gastrointestinal infections in low- to middle-income countries while immunodeficiencies such as chronic granulomatous disease (CGD) are a more common cause in a HIC. Clinical manifestations of hepatic phlegmon can be vague and nonspecific making a complete FUO workup critical during evaluation. We report a case of MRSA hepatic phlegmon in an immunocompetent patient with a nonspecific history and physical exam findings. A 14-year-old male presented with an 11-day history of fever with mild bilateral upper quadrant abdominal pain. The patient also has mild upper quadrant pain with palpation. The patient was diagnosed with a hepatic phlegmon on abdominal ultrasound and computed tomography (CT) of the abdomen. He was started on antibiotics and Interventional Radiology placed drains into the phlegmon and performed vancomycin drain washes. Inflammatory markers were initially elevated and trended down with interventions. The patient did well with treatment and was back to baseline during outpatient follow-up with the Infectious Disease team. This case illustrates the importance of a complete workup in patients with FUO.

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Section: Discussionsupporting

confidence: 81%

Fever of Unknown Origin: A Case Report of Hepatic Phlegmon in an Immunocompetent Patient

Pruitt,

Filipek,

Williford

et al. 2024

Cureus

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“…[14][15][16][17] The triad of fever, pain in the abdomen and tender hepatomegaly were present in nearly three-fourths of our patients reiterating its importance in suspecting LA in children. Yet, nonspecificity of symptoms may lead to delay in diagnosis (nearly 10% of our patients presented with fever only), 4 therefore it is important to have a high index of suspicion.…”

Section: Discussionmentioning

confidence: 99%

“…13 Moreover, recent research reports community-acquired MRSA as the commonest pathogen cultured in liver abscess especially in healthy children who have associated skin or respiratory illness. 4 Although the study enrolled only 20 children, treating physicians should be aware.…”

Section: Discussionmentioning

confidence: 99%

“…Its incidence varies from 4 to 7 cases per 1000 pediatric admissions in developing countries 1,2 compared with 11 to 35 cases per 100000 pediatric admissions in developed countries. 3,4 Limited data from India states an incidence of 79 cases per 1,00,000 pediatric admissions. 5 A few recent studies have reported a substantial number of admissions of pediatric LA over short time frames.…”

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confidence: 99%

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Pediatric Liver Abscess: Outcomes of Protocol-based Management and Predictors of Poor Outcome

Anand

Sahi

Mandal

2023

Pediatric Infectious Disease Journal

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Background: Liver abscess (LA) is an important cause of morbidity in children, especially in tropical countries. There is a paucity of data in pediatric LA with no standard guidelines regarding the best modality of treatment and drainage. With a large influx of patients at our center and protocol-based management; we aimed to study clinic-radiologic profile, risk factors, complications and outcomes of children with liver abscess and assessed possible predictors for poor outcomes. Materials and methods: This retrospective observational study was conducted from January 2019 to September 2019 at a tertiary care hospital in India. Records of all children (<12 years of age) with ultrasonographically diagnosed liver abscess were accessed for clinic-radiological and demographic profile, laboratory investigations, treatment, complications and outcomes. Patients were categorized into favorable or unfavorable groups based on predefined criteria and were compared for possible predictors of poor outcomes. Outcomes for the protocol-based management were analyzed. Results: There were 120 cases of pediatric liver abscess with a median age of 5 years at presentation. The commonest clinical features were fever (100%) and pain in the abdomen (89.16%). The majority of liver abscesses were solitary (78.4%) and in the right lobe (73.3%). Malnutrition was present in 27.5%, overcrowding for 76.5% of patients and worm infestation in 2.5% of patients. Age-related leukocytosis (P = 0.004), neutrophilia (P = 0.013), elevated Aspartate transaminase (P = 0.008), elevated alanine transaminase (P = 0.007) and hypoalbuminemia (P = 0.014) were significantly more in the unfavorable group. Overall, 29.2% of patients underwent conservative management with antibiotics alone, 25.0% underwent percutaneous needle aspiration (PNA), 49.1% underwent ultrasound-guided percutaneous drain (PCD) insertion and open surgical drainage (OSD) was needed in a single patient. The success rate was 100% for conservative management, 76.6% for PNA, 94.7% for PCD and 100% for OSD with an overall mortality of 2.5%. Conclusions: Age-related leukocytosis, neutrophilia, elevated aspartate transaminase or alanine transaminase and hypoalbuminemia at presentation are predictors of poor outcomes in pediatric liver abscess. Protocol-based management leads to the appropriate use of PNA and PCD while decreasing mortality and morbidity related to either.

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Pediatric Hepatic Cystic Lesions: Differential Diagnosis and Multimodality Imaging Approach

et al. 2022

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Absceso hepático piógeno en pediatría: experiencia en un centro pediátrico de referencia

Cited by 4 publications

References 9 publications

Fever of Unknown Origin: A Case Report of Hepatic Phlegmon in an Immunocompetent Patient

Fever of Unknown Origin: A Case Report of Hepatic Phlegmon in an Immunocompetent Patient

Pediatric Liver Abscess: Outcomes of Protocol-based Management and Predictors of Poor Outcome

Pediatric Hepatic Cystic Lesions: Differential Diagnosis and Multimodality Imaging Approach

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