The 39th Annual Meeting of the European Society of Paediatric Infectious Diseases (ESPID), Geneve, Switzerland, 24 - 29 May 2021, vol.1, no.531, pp.861
Background: Pyogenic liver abscesses are rare and fatal in children. In pediatric patients, altered host defenses seem to play an important role. However, pyogenicl iver abscess also occurs in healthy children. We experienced a case of pyogenic liver abscess in a healthy immunocompetent 11-year-oldgirl.
Case Presentation Summary: An 11-year-old previously healthy girl was brought with prolonged fever and right abdominal pain. Fever did not decrease, despite 7 days of treatment with ceftriaxone and amikacin in the previous center. Physical examination was normal except for fever and hepatomegaly. Initial laboratory tests showed leucocyte 12.850/mm3 (neutrophils 72%), hemoglobin 8.5 g/dl, C-reactive protein 63 mg/dL, and erythrocyte sedimentation rate 109 mm/h. Aminotransferase levels were within the normal ranges. Abdominal ultrasonography showed a 6.5 cm-sized peripherally enhancing, centrally hypoattenuating lesions, consistent with abscess. A computed tomography scan of the abdomen with IV contrasts showed large hepatic abscesses in segments 6 and 7. The patient was started ceftriaxone, vancomycin, and metronidazole and underwent ultrasound-guided percutaneous drainage of the largest hepatic abscess by interventional radiology and pediatric surgery specialist. Staphylococcus aureus grew in the pus culture. The patient improved clinically and was subsequently discharged on day 14 of admission. The patient's control ultrasonography showed that the abscess was resolved in polyclinic controls.
Learning Points/Discussion: A rare cause of prolonged fever and fever of unknown origin in children is
the pyogenic liver abscess. This report describes a case of a pyogenic liver abscess caused by penicillinresistant Staphylococcus aureus in a healthy 11-year-old girl. The patient was successfully treated with
intravenous administration of antibiotics and percutaneous drainage of the abscess.