c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Multiple Liver Abscesses: 1

A D V E R T I S E M E N T

   

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A 42-year-old man presented with a two week history of fever, chills, anorexia, weight loss, left lower quadrant pain, elevated liver enzymes and white blood count. CT scan showed multiple rim-enhancing liver collections. Percutaneous drains were placed in those that were accessible and the patient was transferred to a higher-level facility for further treatment. Smear of the abscess contents showed gram-positive cocci in single, paired and chain form. The patient was started on erdepenem.   

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Multiple Liver Abscesses: 2

A D V E R T I S E M E N T

   

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The patient had a history of diverticulitis (see sigmoid diverticulitis) which resolved with non-operative management 1 year prior to the present illness. The patient had had vigorous dental cleaning two weeks prior to the onset of the present illness. Echocardiogram was normal with no evidence of valvular vegetations. The patientís left lower quadrant pain was resolving at the time of transfer. CT scan showed evidence of uncomplicated sigmoid diverticulitis. Abscess cultures grew out strep intermedius (Millerii group) and the antibiotic was changed to levofloxicin based on sensitivity.   

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Multiple Liver Abscesses: 3

A D V E R T I S E M E N T

   

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Additional percutaneous catheters were placed in the less accessible cavities.     

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This page was last modified on 12/4/2007.