Non-typhoidal salmonellosis, which is increasing nowadays in Korea as well as in the developed countries, is manifested as enteritis in most cases, but it also encompasses bacteremia, intraabdominal infections, and bone, joint and soft tissue infections. These rare diseases are known to result from primary gastrointestinal infection and subsequent bacteremia with or without symptoms. We experienced a case of neck abscess caused by Salmonella serotype D, which is a rare but important differential diagnosis of neck abscess. We herein report it.
Abscess/*diagnosis/*microbiology ; Aged ; Female ; Humans ; *Liver Cirrhosis ; Neck/*microbiology/*pathology ; Salmonella/*physiology ; Salmonella Infections/*complications

Clostridial septicemia usually occurrs in patients with immunocompromised diseases such as diabetes and malignancy. Clostridial liver abscess is very rare but highly fatal. We experienced a case of Clostridial septicemia due to liver abscess in a 73-year-old man. He was presented with fever and chills. On admission, abdominal CT scan showed about 35 mm sized hypoattenuated lesion with multiple central air-bubbles. After the diagnosis of liver abscess, the patient underwent prompt empirical antimicrobial therapy and percutaneous drainage. In spite of early therapy, the patient had gone into shock and death.
Aged ; Clostridium/*isolation & purification ; Clostridium Infections/diagnosis/*microbiology ; Drainage ; Humans ; Liver/radiography ; Liver Abscess/complications/*diagnosis/microbiology ; Male ; Sepsis/complications/*diagnosis ; Tomography, X-Ray Computed

Primary hepatic actinomycosis is one of the chronic abscess-forming infections of the liver. Accurate diagnosis is frequently delayed due to its indolent course and nonspecific clinical and radiological manifestations. We report a case of a 57-year-old man presenting with asymptomatic multiple hepatic masses on follow-up abdominal computed tomography performed 1 year after stomach cancer surgery. Although a percutaneous liver biopsy procedure was conducted twice in order to obtain confirmative pathology, only a nonspecific organizing abscess with plasma cell infiltration was revealed, without identification of any organism in the tissue cultures. Ultimately, actinomycosis was diagnosed following the detection of sulfur granules on open surgical biopsied tissue. This case suggests that primary hepatic actinomycosis should be considered as one of the possible causes for enigmatic inflammatory lesions of the liver.
Actinomycosis/*diagnosis/drug therapy/microbiology ; Anti-Bacterial Agents/therapeutic use ; Biopsy, Needle ; Humans ; Liver Abscess/complications ; Liver Diseases/*diagnosis/microbiology/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Klebsiella pneumoniae is emerging as the leading cause for liver abscess although the most common pathogen was Escherichia coli in the past. Patients with diabetes mellitus are more likely to have a pyogenic liver abscess with gas forming infection; a gas forming pyogenic liver abscess carries a higher morbidity and mortality than the non-gas forming group. This study was conducted to clarify the clinical presentation and prognostic factors for pyogenic liver abscess in diabetic patients compared with non-diabetic patients. METHODS: Medical records of 140 cases of patients treated for pyogenic liver abscess from January 1995 through January 2004 were reviewed retrospectively in detail. RESULTS: Among 140 cases of pyogenic liver abscess, underlying diabetes was present in 26.4% (37/140). The clinical presentation between the two groups was not significantly different. The most common organism for the pyogenic abscess was K. pneumoniae in both groups. A gas forming liver abscess was discovered in only the diabetic liver abscess group, 6 of 37 patients (16%). CONCLUSIONS: K. pneumoniae was the most common organism cultured in both diabetic and non-diabetic liver abscess. Gas forming liver abscess was more common in diabetic patients than non-diabetic patients. Diabetic patients had more complications than non-diabetic patients.
Adult ; Aged ; *Diabetes Complications ; Female ; Humans ; Klebsiella Infections/complications ; Klebsiella pneumoniae ; Liver Abscess, Pyogenic/*complications/diagnosis/microbiology ; Male ; Middle Aged ; Prognosis

BACKGROUND/AIMS: Despite the improvement of personal and social hygiene, pyogenic liver abscess is still a common disease. We compared the incidence, infection route, underlying disease and major complications between two different local hospitals. METHODS: We reviewed the clinical data of 100 patients with pyogenic liver abscess who were treated at Seoul and Guri Hanyang University Hospital from 1999 to 2003. RESULTS: There were 64 males and 36 females in the study group; they were aged from 19 to 94 years with a mean of 56.5 years. Every year 19 to 23 pyogenic liver abscess patients were admitted to both hospitals. The most common organism isolated was Klebsiella pneumoniae in both local hospitals. In the Seoul hospital, diabetes (40.9%) was most common associated condition. In the Guri hospital, biliary tract disease or a history of hepatobiliary surgery (54.2%) was the most common associated condition. Catheter drainage and/or percutaneous needle aspiration were established as the standard treatment modality. CONCLUSIONS: In both regional hospitals, the incidence of pyogenic liver abscess did not decrease and Klebsiella pneumoniae was the most common organism. Diabetes and biliary tract disease, including, previous hepatobiliary surgery, were the most identifiable underlying disease.
Adult ; Aged ; Aged, 80 and over ; English Abstract ; Female ; Humans ; Klebsiella Infections/complications/diagnosis/therapy ; Klebsiella pneumoniae ; *Liver Abscess, Pyogenic/complications/microbiology/therapy ; Male ; Middle Aged

BACKGROUND/AIMS: Hepatic or splenic lesions in hematologic patients are not defined well because they are not easy to evaluate due to limitations of invasive procedures. Management typically depends on the clinical diagnosis with few microbiological data. METHODS: We reviewed the medical records of consecutive hematologic patients with hepatic or splenic lesions in the infectious diseases unit from April 2009 to December 2010 at the Catholic Hematopoietic Stem Cell Transplantation Center in Korea. RESULTS: Twenty-six patients were identified. Their mean age was 46.0 +/- 14.7 years, and 16 (61.5%) were male. Underlying diseases were acute myelogenous leukemia (n = 15, 57.7%) and myelodysplastic syndrome (n = 6, 23.1%). Among the nine nontuberculous infectious lesions, two bacterial, six fungal, and one combined infection were identified. The numbers of confirmed, probable, and possible tuberculosis (TB) cases were one, three, and four, respectively. Two patients had concurrent pulmonary TB. QuantiFERON-TB Gold In-Tube (QFT-GIT, Cellestis Ltd.) was positive in seven cases, among which six were diagnosed with TB. The sensitivity and specificity of QFT-GIT were 75% and 81.3%. Nine (34.6%) were defined as noninfectious causes. CONCLUSIONS: Causes of hepatic or splenic lesion in hematologic patients were diverse including TB, non-TB organisms, and noninfectious origins. TB should be considered for patients not responding to antibacterial or antifungal drugs, even in the absence of direct microbiological evidence. QFT-GIT may be useful for a differential diagnosis of hepatosplenic lesions in hematologic patients.
Abscess/*diagnosis/microbiology/mortality/therapy ; Adult ; Anti-Infective Agents/therapeutic use ; Chi-Square Distribution ; Female ; Hematologic Diseases/*complications/mortality ; Humans ; *Interferon-gamma Release Tests ; Liver Abscess/*diagnosis/microbiology/mortality/therapy ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Splenic Diseases/*diagnosis/microbiology/mortality/therapy ; Time Factors ; Tuberculosis/*diagnosis/microbiology/mortality/therapy

Intrahepatic abscess is an unusual complication of peptic ulcer disease. We present a case of gastric cancer in which the ulcer penetrated into the left lobe of liver with subsequent abscess and fistula formation. Esophagogastroduodenoscopy confirmed ulcers and a fistula opening in the antrum. Abdominal computed tomogram showed a subcapsular liver abscess adjacent to the gastric antrum. Subtotal gastrectomy with curettage of the fistulous tract was performed. The final diagnosis was the signet ring cell gastric carcinoma complicating subcapsular liver abscess. To our knowledge, this is the first reported case in Korea.
Endoscopy, Gastrointestinal ; Female ; Humans ; Klebsiella pneumoniae/isolation & purification ; Liver Abscess/diagnosis/*etiology/microbiology ; Middle Aged ; Peptic Ulcer Perforation/*complications/diagnosis ; Stomach Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2x6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.
Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Fusobacterium Infections/complications/*diagnosis/drug therapy ; Fusobacterium nucleatum/*isolation & purification ; Humans ; Injections, Intravenous ; Liver Abscess/*diagnosis/etiology/microbiology ; Male ; Middle Aged ; Periodontal Diseases/*diagnosis ; Sulbactam/therapeutic use

Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.
Abscess/microbiology ; Aged ; Anti-Bacterial Agents/therapeutic use ; Carcinoma, Hepatocellular/*complications/*therapy ; Chemoembolization, Therapeutic/*adverse effects ; Cholangiopancreatography, Endoscopic Retrograde ; Citrobacter freundii/isolation & purification ; Drainage ; Drug Resistance, Multiple, Bacterial ; Enterobacteriaceae Infections/drug therapy ; Hepatitis B/complications ; Humans ; Klebsiella/isolation & purification ; Klebsiella Infections/drug therapy ; Liver Cirrhosis/etiology ; Liver Neoplasms/*complications/*therapy ; Male ; Necrosis/*diagnosis/etiology ; Pancreatitis/*diagnosis/etiology ; Tomography, X-Ray Computed

Lactococcus lactis cremoris infections are very rare in humans. We experienced liver abscess and empyema due to L. lactis cremoris in an immunocompetent adult. A 42-yr-old man was admitted with fever and abdominal pain. Abdominal computed tomography (CT) revealed a liver abscess and chest CT showed loculated pleural effusion consistent with empyema. L. lactis cremoris was isolated from culture of the abscess material and blood. The patient was treated with pus drainage from liver abscess, video-assisted thoracoscopic decortications for empyema, and antibiotics including cefotaxime and levofloxacin. The patient was completely recovered with the treatment. To our knowledge, this is the first report of a L. lactis cremoris infection in Korea.
Adult ; Anti-Bacterial Agents/therapeutic use ; Cefotaxime/therapeutic use ; Drainage ; Empyema/*diagnosis/*microbiology/surgery ; Gram-Positive Bacterial Infections/complications/*diagnosis/drug therapy ; Humans ; *Lactococcus lactis/drug effects/isolation & purification ; Liver Abscess/*diagnosis/*microbiology ; Male ; Microbial Sensitivity Tests ; Ofloxacin/therapeutic use ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed