An unusual case of aggregatibacter aphrophilus liver abscess

Abstract

Liver abscess of oropharyngeal origin in an immunocompetent patient is a rare condition. Furthermore, microbiologic diagnosis of liver abscess can be challenging due to the tremendous diversity of the microorganisms implicated and culture difficulties under laboratory conditions. We report a case of a previously healthy 23-year-old male, who presented multiple liver abscesses, attributed to aggregatibacter aphrophilus , an obligatory oral gram-negative microorganism, that normally is a component of the commensal oral microbiota and non-virulent. The etiopathogenic microorganism was identified after needle aspiration of a liver abscess cavity. Treatment with broad-spectrum antimicrobials and percutaneous catheter drainage under computed tomography guidance of both abscesses, resulted in full recovery. A. aphrophilus represents a rare entity of liver abscess in healthy individuals and suggests that a pathogen of oropharyngeal origin should be suspected when an overt source of infection cannot be documented.

The First Known Case of Liver Abscess Caused by <i>Aggregatibacter aphrophilus</i> in Japan

“…Consequently, there is no consensus concerning the most appropriate antibiotic choice. In previous reports, liver abscesses caused by A. aphrophilus have been treated with ciprofloxacin, gentamicin, and ampicillin/sulbactam (9,10). Based on the present findings, we believe that amoxicillin or ampicillin with a β-lactamase inhibitor, such as ceftriaxone or cefotaxime, or a fluoroquinolone may be effective in patients with A. aphrophilus infections (5).…”

“…To our knowledge, in the literature, only three cases of liver abscess caused by A. aphrophilus have been reported ( 9 - 11 ). One of three patients had undergone a recent minor dental procedure, and the others had not.…”

Invasive Aggregatibacter infection: shedding light on a rare pathogen in a retrospective cohort analysis

“…A. aphrophilus is well recognized as a cause of brain abscesses and has also been implicated in a range of invasive infections, including endocarditis, spinal abscess, liver abscess and acute appendicitis [14][15][16][17][33][34][35][36]. One patient with brain abscess in this series had A. aphrophilus cultured from neurosurgical intraoperative samples, while another with A. aphrophilus endocarditis had cerebral septic emboli, highlighting the particular affinity of this species for the brain parenchyma.…”

“… A. aphrophilus is well recognized as a cause of brain abscesses and has also been implicated in a range of invasive infections, including endocarditis, spinal abscess, liver abscess and acute appendicitis [14–17, 33–36]. One patient with brain abscess in this series had A.…”