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©2012 Baishideng. All rights reserved.
World J Hepatol. Aug 27, 2012; 4(8): 252-255
Published online Aug 27, 2012. doi: 10.4254/wjh.v4.i8.252
Published online Aug 27, 2012. doi: 10.4254/wjh.v4.i8.252
A middle-aged lady with a pyogenic liver abscess caused by Clostridium perfringens
Siu-Tong Law, Ming Kai Lee, Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
Author contributions: Law ST and Lee MK were responsible for the patient care; Law ST was also responsible for the conception and writing of the manuscript; all authors read and approved the final manuscript.
Correspondence to: Siu-Tong Law, MBBS, FHKCP, FHKAM, Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China. stl168@hotmail.com
Telephone: +852-24685386 Fax: +852-24685389
Received: March 26, 2011
Revised: August 6, 2012
Accepted: August 23, 2012
Published online: August 27, 2012
Revised: August 6, 2012
Accepted: August 23, 2012
Published online: August 27, 2012
Abstract
The pyogenic liver abscess caused by Clostridium perfringens (C. perfringens) is a rare, but rapidly fatal infection. It is usually associated with malignancy and immunosuppression. We report the case of 50-year-old lady with the secondary liver metastases from rectal cancer presented with fever and epigastric pain. The identification of Gram-positive bacilli septicaemia, the presence of gas-forming liver abscess and massive intravascular hemolysis should lead to the suspicion of C. perfringens infection. Here we review twenty cases published since 1990 and their clinical features are discussed. The importance of ”an aggressive treatment policy” with multidisciplinary team approach is emphasized.
Keywords: Pyogenic liver abscess, Clostridium perfringens, Infected hepatic metastases, Liver abscess, Gram-positive bacilli septicaemia