Brucella liver abscess; imaging approach, differential diagnosis, and therapeutic management: a case report

Chourmouzi, Danai; Boulogianni, Glykeria; Kalomenopoulou, Maria; Kanellos, Ioannis; Drevelegas, Antonios

doi:10.4076/1757-1626-2-7143

Cited by 19 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of polymerase chain reaction (PCR) was reported from blood samples in seven patients and from pus or biopsy material in seven patients; in all 14 samples Brucella DNA was isolated. [17][18][19][20] Treatment and outcome. In 90 cases, the antibiotic regimen was specified; in the remaining "Brucella-specific antibiotic treatment" was reported.…”

Section: Resultsmentioning

confidence: 99%

Patterns of Hepatosplenic Brucella Abscesses on Cross-Sectional Imaging: A Review of Clinical and Imaging Features

Heller

Bélard

Wallrauch

et al. 2015

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. While diffuse involvement of liver and spleen is frequently seen in brucellosis, suppurative abscesses caused by Brucella are less common but well described. With the increased availability of cross-sectional imaging techniques, reports have become more frequent. Four patients with hepatosplenic abscesses caused by Brucella spp. are described and included in a review of 115 previously published cases. Clinical characteristics and patterns on ultrasound (US) and computed tomography imaging were analyzed. Furthermore, the proportion of patients with brucellosis affected by suppurative hepatosplenic lesions was estimated. Hepatosplenic abscesses were seen in 1.2% of patients with brucellosis and were mostly caused by Brucella melitensis. Imaging analysis revealed two main distinct patterns. Solitary abscesses involving liver more frequently than spleen, and showing characteristic central calcifications, characterize the first pattern. Multiple smaller abscesses, frequent spleen involvement, and absence of calcifications characterize the second pattern. Blood and aspirate cultures were frequently negative, however, the positivity rate increased over the past years. Indirect Coombs test was positive in 96%. Half of the patients were cured by antibiotic treatment; case fatality in this series was 1.9%. Hepatosplenic abscesses due to Brucella infections have characteristic imaging findings. Clinicians should be aware of these and the proactive use of cross-sectional imaging, particularly US, should be encouraged in endemic regions.

show abstract

Section: Resultsmentioning

confidence: 99%

Patterns of Hepatosplenic Brucella Abscesses on Cross-Sectional Imaging: A Review of Clinical and Imaging Features

Heller

Bélard

Wallrauch

et al. 2015

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…Liver MRI is not essential to the diagnosis. It shows elements similar to pyogenic liver abscess with a multilocular lesion including a group of cystic lesions of various sizes with a hypointense signal on T1-weighted images and a hyperintense signal on T2-weighted images [6]. Enhancement of the walls during the arterial phase, persists during the delayed phase as well as enhancement of the adjacent liver parenchyma during the arterial phase because of inflammation.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing pseudotumoral hepatic brucelloma: Imaging-pathologic correlation

Moigne

Vitry

Gérôme

et al. 2016

Diagnostic and Interventional Imaging

View full text Add to dashboard Cite

KEYWORDS Brucelloma; Liver abscess; CalcificationObservation A 62-year old Algerian patient with no prior medical history was admitted to the emergency unit for upper right quadrant pain after deterioration of his general condition for 2 months. Clinical examination was normal. Biological tests showed elevated C-reactive protein without hyperleucocytosis. Liver tests showed moderate cholestasis without jaundice or associated cytolysis. Liver ultrasound showed a large heterogenous 11 cm mass in the right liver with a central macrocalcification. Abdominopelvic CT examination showed a hypodense mass with irregular borders and a calcification in the centre, strongly suggesting an infectious lesion (Fig. 1). Liver MRI (Fig. 2) showed a multilocular lesion with numerous fluid signal compartments and restricted diffusion. Microbiological agglutination tests (Wright and Rose Bengal reaction) were positive and suggested brucellosis. Fine needle ultrasound-guided biopsy of the lesion revealed pus that was shown to be due to Gram-negative bacteria that was further confirmed as Brucella melitensis after 5 days of incubation. A Brucella liver abscess was

show abstract

“…To our knowledge, the only focal infectious lesion that has a central calcification is brucellar abscess (Figure 6) [23, 24]. …”

Section: Discussionmentioning

confidence: 99%

Extrahepatic Textiloma Long Misdiagnosed as Calcified Echinococcal Cyst

Cattaneo

Graffeo

Brunetti

2013

Case Reports in Gastrointestinal Medicine

View full text Add to dashboard Cite

Textiloma or gossypiboma is a retained surgical swab in the body after an operation and is a complication that can remain undetected for many years and may represent a diagnostic dilemma depending on its location. It may be confused with several focal lesions and an accurate history taking, combined with clinical and instrumental data, is key to suspecting the diagnosis. We report a case of abdominal textiloma that was initially misdiagnosed as echinococcal cyst and discuss the differential diagnosis based on sonographic features and the WHO-IWGE classification.

show abstract

Brucella liver abscess; imaging approach, differential diagnosis, and therapeutic management: a case report

Cited by 19 publications

References 12 publications

Patterns of Hepatosplenic Brucella Abscesses on Cross-Sectional Imaging: A Review of Clinical and Imaging Features

Patterns of Hepatosplenic Brucella Abscesses on Cross-Sectional Imaging: A Review of Clinical and Imaging Features

Necrotizing pseudotumoral hepatic brucelloma: Imaging-pathologic correlation

Extrahepatic Textiloma Long Misdiagnosed as Calcified Echinococcal Cyst

Contact Info

Product

Resources

About