Haemophilus parainfluenzae Pyogenic Liver Abscess Associated With Cholangiocarcinoma

Mathew C Finniss,Lamis Ibrahim

doi:10.7759/cureus.22501

Abstract

Haemophilus parainfluenzae (H. parainfluenzae) is a commensal organism of the gastrointestinal tract. It rarely causes hepatobiliary infections; however, in the presence of underlying inflammation, immunosuppression, or malignancy, it can cause hepatobiliary infection via an ascending route. Herein, we report a case of pyogenic liver abscess secondary to H. parainfluenzae associated with cholangiocarcinoma, which was treated with ceftriaxone and metronidazole.

Highlights

Haemophilus parainfluenzae is known to cause meningitis, epiglottitis, pneumonia, bacteremia, endocarditis, and a wide variety of other infections [1-4]
We report a case of H. parainfluenzae pyogenic liver abscess associated with cholangiocarcinoma
A literature review published by Athreya et al identified five cases of H. parainfluenzae pyogenic liver abscess while a separate report from Friedl et al identified two cases of H. parainfluenzae biliary tract infection [3,5]

Summary

Introduction

Haemophilus parainfluenzae is known to cause meningitis, epiglottitis, pneumonia, bacteremia, endocarditis, and a wide variety of other infections [1-4]. Only five cases of H. parainfluenzae pyogenic liver abscesses and two cases of H. parainfluenzae biliary tract infection have been reported [3]. She underwent CT-guided percutaneous drainage of the liver abscess and fluid cultures were positive for H. parainfluenzae. Magnetic resonance cholangiopancreatography was done to evaluate the relation of the gallbladder and biliary anatomy to the liver abscess and demonstrated ruptured cholecystitis communicating with the intrahepatic abscess as well as narrowing of the common bile duct. She underwent open cholecystectomy and drainage of the intrahepatic abscess. Blood cultures remained negative throughout and she was successfully treated with a four-week course of ceftriaxone and metronidazole

Discussion

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Conclusions

Disclosures