Abstract

BackgroundA pyogenic liver abscess (PLA) represents a pus-filled cavity within the liver parenchyma caused by the invasion and multiplication of bacteria. The most common offender isolated from the PLA in children is Staphylococcus aureus. Abiotrophia defectiva is a Gram-positive pleomorphic bacterium, commonly found in the oral cavity, intestinal, and genitourinary mucosa as part of the normal microbiota. It has been proven to be an etiological factor in various infections, but rarely in cases of PLA. The case presented here is, to the best of our knowledge, the first pediatric case of PLA caused by A. defectiva.Case presentationA 13-year-old Caucasian boy presented with a two-day history of abdominal pain, fever up to 40 °C, and polyuria. Contrast-enhanced computed tomography (CT) scan revealed a single, multiloculated liver lesion, suggestive of a liver abscess. The boy had sustained a bicycle handlebar injury to his upper abdomen 3 weeks before the symptoms appeared and had been completely asymptomatic until 2 days before admission. He was successfully treated with antibiotic therapy and open surgical drainage. A. defectiva was isolated from the abscess material. Histopathology report described the lesion as a chronic PLA.ConclusionsA. defectiva is a highly uncommon cause of liver abscess in children. In such cases, various predisposing factors should be considered, including antecedent blunt abdominal trauma.

Highlights

  • A liver abscess (LA) represents a pus-filled cavity within the liver parenchyma caused by the invasion and multiplication of microorganisms

  • We present a case of a teenage boy with a pyogenic liver abscess caused by Abiotrophia defectiva, which is, to the best of our knowledge, the first reported pediatric case of PLA caused by this organism

  • The patient was doing well after 3 months of follow-up. His physical examination and laboratory tests showed no abnormalities, and the abdominal ultrasound imaging indicated that pyogenic liver abscess had resolved to almost normal liver parenchyma

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Summary

Conclusions

A. defectiva is a highly uncommon cause of liver abscess in children. In such cases, various predisposing factors should be considered, including antecedent blunt abdominal trauma.

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