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Pyogenic liver abscess in a child with concomitant infections – Staphylococcus aureus, Echinococcus multilocularis and Mycobacterium tuberculosis


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Fig. 1

CT images revealed hepatomegaly (up to 16 cm) with large non-homogenous, hypodense lobulated lesions in all right liver lobe segments and in S1 and S4 segments. Axial view (a) and coronal view (b).
CT images revealed hepatomegaly (up to 16 cm) with large non-homogenous, hypodense lobulated lesions in all right liver lobe segments and in S1 and S4 segments. Axial view (a) and coronal view (b).

Fig. 2

Ultrasound of the liver during the last control of the patient confirmed almost physiological findings with discretely irregularly mixed echogenicity of right liver lobe parenchyma
Ultrasound of the liver during the last control of the patient confirmed almost physiological findings with discretely irregularly mixed echogenicity of right liver lobe parenchyma

Trends of laboratory tests results

PARAMETERRefer. valuesDay 1Day 3Day 7Day 11Day 14Day 21
Leukocytes (per mm3)4.5 – 1320.5340.8537.8935.8213.0914.21
Neutrophils (per mm3)1.8 – 7.014.7432.0530.1727.279.657.47
Haemoglobin (g/l)118 – 1501041068180105102
Platelets (per mm3)150 – 4402484508441250998723
C-reactive protein (mg/l)< 5169.9133.9215.7118.971.822.3
Gama glutamine transferase (μkat/l)0.08 – 0.41.01.243.446.094.95
Alanine aminotransferase (μkat/l)0.05 – 0.781.250.730.410.280.21
Albumin (g/l)35 – 5327.928.730.335.5
Procalcitonin (μg/l)< 0.53.256.690.7890.12

Results of serological and parasitological examinations

EXAMINATIONPARAMETER/TESTRESULT
PARASITOLOGICALE. multilocularis PCR (liver sample)POSITIVE
E. granulosus IgG antibodiesNegative
E. multilocularis IgG antibodiesNegative
Toxocara IgG antibodiesPOSITIVE
Toxoplasma IgG antibodiesPOSITIVE
Parasitological stool examinationAscaris lumbricoides Trichuris trichiura
BACTERIOLOGICALMicrobiological cultivation (liver sample)Staphylococcus aureus
Mycobacterium tuberculosis PCR (liver sample)POSITIVE
Mycobacterium tuberculosis Tests (Quantiferon test; Tuberculin Skin test; Microscopy and cultivation for Acid-fast bacilli from respiratory and gastric aspirates; SPOT assay)Negative
Yersinia enterocoliticaNegative
Hemo-culture

S. maltophilia detected on day 12; former hemo-cultures were negative

Stenotrophomonasmaltophilia

S. maltophilia detected on day 12; former hemo-cultures were negative

VIROLOGICALCytomegalovirusNegative
HIV testNegative
Viral hepatitisNegative
Epstein-Barr virusNegative
FUNGALCandida mannan antigenPOSITIVE
eISSN:
1336-9083
ISSN:
0440-6605
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Life Sciences, Zoology, Ecology, other, Medicine, Clinical Medicine, Microbiology, Virology and Infection Epidemiology