Emphysematous liver abscess in a 58-year-old woman

Abstract

A 58-year-old woman with hypertension and type 2 diabetes mellitus presented to the emergency department after five days of fever, malaise, cough and epigastric pain. On examination, the patient's temperature was 40.8°C, pulse rate 133 beats/min and blood pressure 159/73 mm Hg. Laboratory investigations showed no leukocytosis (white blood cell count 6.2 [normal range 3.2-9.2] × 10 9 /L), but an excess of immature white blood cells of 21% (0%-3%), random serum glucose level of 22.2 (normal range 3.9-5.6) mmol/L, glycosylated hemoglobin (HbA 1c) of 11.2% (< 5.7%), alanine transaminase of 144 (normal range 2-40) U/L and serum creatinine level of 75.1 (normal range 50.4-98.1) μmol/L. A chest radiograph showed an air-fluid level lesion over the right subphrenic region (Appendix 1, available at www.cmaj.ca/lookup/suppl/

A rare emphysematous splenic infection caused by diabetes mellitus: a case report

“…Emphysematous infection causes a wide variety of lifethreatening pathological conditions in which carbon dioxide, nitrogen, or other types of gases, generated from bacterial fermentation, fill the walls of hollow organs or the parenchyma of solid organs. This aggressive form of sepsis has been documented to violate various organs, including the stomach, intestine, liver, kidney, gallbladder, urinary bladder, urinary tract, prostate, spine, pancreas, and even the spleen (1)(2)(3)(4)(5)(6)(7)(8). Certain species of bacteria, such as Escherichia coli, can consume nutritional components in circulation or interstitial fluid, and produce gas, especially under extreme circumstances, such as hyperglycemia (9).…”