Actinomycotic liver abscess: A rare complication of colonic diverticular disease

Joshi, Vijay V.; Koulaouzidis, Anastasios; McGoldrick, Steve; Tighe, M.J.; Tan, Chew

doi:10.1016/s1665-2681(19)31688-6

Cited by 12 publications

(7 citation statements)

References 5 publications

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“…Actinomycosis of the liver, the biliary tract, and the pancreas has also been described 80,81. Liver involvement mimicking malignancy or presenting as an abscess could be associated with digestive tract disease such as colonic diverticular disease.…”

Section: Clinical Features Of Actinomycosismentioning

confidence: 99%

“…Patients with ulcerative involvement of the esophagus mainly have dysphagia; patients with appendix, cecum, or colon actinomycosis frequently have abdominal pain with a palpable mass; patients with liver and biliary tract actinomycosis frequently have right upper quadrant pain and icterus 80,81…”

Section: Clinical Features Of Actinomycosismentioning

confidence: 99%

“…Surgery is required in complicated cases, such as in patients with fistula and cell wall involvement 80,81…”

Section: Clinical Features Of Actinomycosismentioning

confidence: 99%

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Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

Valour¹,

Sénéchal²,

Dupieux³

et al. 2014

IDR

386

457

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Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with poor dental hygiene), but also that actinomycosis may mimic the malignancy process in various anatomical sites. Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with yellowish sulfur granules and filamentous Gram-positive fungal-like pathogens. Patients with actinomycosis require prolonged (6- to 12-month) high doses (to facilitate the drug penetration in abscess and in infected tissues) of penicillin G or amoxicillin, but the duration of antimicrobial therapy could probably be shortened to 3 months in patients in whom optimal surgical resection of infected tissues has been performed. Preventive measures, such as reduction of alcohol abuse and improvement of dental hygiene, may limit occurrence of pulmonary, cervicofacial, and central nervous system actinomycosis. In women, intrauterine devices must be changed every 5 years in order to limit the occurrence of pelvic actinomycosis.

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Section: Clinical Features Of Actinomycosismentioning

confidence: 99%

Section: Clinical Features Of Actinomycosismentioning

confidence: 99%

See 1 more Smart Citation

Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

Valour¹,

Sénéchal²,

Dupieux³

et al. 2014

IDR

386

457

View full text Add to dashboard Cite

show abstract

“…If a study gave no information in a particular data category, it was marked as "not available" (NA). The search yielded 11 case studies, with one patient per study [6][7][8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Colonic Diverticulitis Complicated by Liver Abscess: Case Series and Review of Literature

Uffenheimer

Kohanteb

Liu

et al. 2018

IGH

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Aim: Evaluate patients with colonic diverticulitis complicated by liver abscesses at a single center and provide review of literature.Methods: Patients with colonic diverticulitis and liver abscess were identified via an administrative database and imaging search engine at Cedars Sinai Medical Center (CSMC). Clinical manifestations, laboratory and imaging findings and treatment strategies were assessed.Results: We identified 10 patients with a median age of 59 and a 7:3 male: female ratio. The top presenting signs and symptoms were: fever (90%), malaise (70%), anorexia (60%), nausea (40%), and right upper quadrant abdominal pain (30%). Mean white blood cell count was 22.4 1000/UL, total bilirubin 2.59 mg/DL, and alkaline phosphatase 206.6 IU/L. Of the reported liver abscess cultures, 5 patients grew a single organism and 2 had multiple organisms. Most common bacteria genus was Streptococcus (n=4). Five patients had right hepatic abscesses, 3 had bilobar, and 2 had left hepatic abscesses. Four patients had locally complicated diverticulitis: 2 with paracolonic abscess and 2 with purulent peritonitis. Nine patients had CT-guided drainage of liver abscess, while 2 needed surgical drainage of liver abscess (one required both). Five patients had colectomy: 1 emergently and 4 electively. Two patients who did not have colectomy had recurrent diverticulitis, and underwent colectomy following recurrence.Conclusion: Majority of patients with diverticulitis with liver abscess were males presenting with fever, and leukocytosis. Most had right liver lobe abscesses and most underwent colectomies. Diverticulitis with liver abscess is likely best treated as locally complicated disease and should undergo colectomy.

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“… 18 , 19 , 20 , 21 Actinomycosis , caused by Actinomyces israelii , a filamentous gram-positive rod, can present with liver involvement in rare instances. Whereas hepatic abscess is the most common presentation of actinomycosis, 22 affected patients may also follow a more indolent course of fever, abdominal pain, and anorexia associated nearly universally with increases of the serum alkaline phosphatase level. 23 Biopsies of infected tissue show characteristic sulfur granules, and treatment with penicillin or tetracycline is usually curative.…”

Section: Bacterial Infectionsmentioning

confidence: 99%

Systemic Causes of Cholestasis

deLemos

2013

Clinics in Liver Disease

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Systemic causes of cholestasis constitute a diverse group of diseases across organ systems. The pathophysiology of cholestasis in systemic disease can be a consequence of direct involvement of a disease process within the liver or extrahepatic biliary system or secondary to immune-mediated changes in bile flow. Evaluating a patient with cholestasis for a systemic cause requires an understanding of the patient’s risk factors, clinical setting (eg, hospitalized or immunosuppressed patient), clinical features, and pattern of laboratory abnormalities.

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Actinomycotic liver abscess: A rare complication of colonic diverticular disease

Cited by 12 publications

References 5 publications

Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

Colonic Diverticulitis Complicated by Liver Abscess: Case Series and Review of Literature

Systemic Causes of Cholestasis

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