Hepatic Abscesses in Preterm Infants: Report of Three Cases and Review of the Literature

Abstract

We suggest evaluating all preterm neonates who have severe sepsis and/or necrotizing enterocolitis signs and who do not respond to prolonged antibiotic therapy with detailed abdominal ultrasound for possible hepatic abscesses as early diagnosis, and treatment favors prognosis.

Liver Abscess in a Term Baby: A Case Report and Review of Literature

“…Neonatal liver abscess is a rare but serious disorder associated with high mortality and morbidity [1][2][3][4][5]. Tan et al [4] reported six cases of neonatal liver abscess in 2005 and reviewed the incidence since 1930.…”

“…Most of these cases were term babies. Between 2005 and 2013, 27 more cases were reported [3]; the majority of which were preterm babies [2,3]…”

“…US findings of neonatal liver abscess may be similar to those of hepatoblastoma, infantile hemangioendothelioma, and hepatic hamartoma. Serum α-fetoprotein levels may be helpful in differentiating these malignant and benign hepatic masses from liver abscesses [2]. Abdominal CT (with and without contrast) gives a firm diagnosis and also defines the extent, structure (single or multiloculated), and any connections with the UVC or central lines.…”

“…have also been published [5]. The microorganisms may enter the liver and produce an abscess by four possible mechanisms: (1) an ascending infection via the umbilical and portal veins; (2) hematogenous spread; (3) ascending infection via the biliary tract; and (4) by direct contiguous spread from neighboring organs [2][3][4][5][6]. TPN extravasation through a UVC tip sited in the liver substance can also cause necrosis and abscess formation.…”

“…A solitary liver abscess is usually large, either uni or multiloculated, well localized, and easily drainable. The solitary liver abscesses have been associated with TPN administration via UVC and usually run a subacute course [2].…”