Hepatic abscesses in the immunocompromised patient: Role of CT in detection, diagnosis, management, and follow-up

Francis, Isaac R.; Glazer, Gary M.; Amendola, Marco A.; Trenkner, Stephen W.

doi:10.1007/bf02035085

Cited by 21 publications

(2 citation statements)

References 23 publications

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“…At contrast-enhanced CT, fungal microabscesses usually appear as multiple round, discrete areas of low attenuation, generally ranging from 2 to 20 mm (Fig 19). These microabscesses usually enhance centrally after intravenous administration of contrast medium, although peripheral enhancement may occur (33)(34)(35).…”

Section: Candidiasismentioning

confidence: 99%

The Infected Liver: Radiologic-Pathologic Correlation

Mortelé¹,

Segatto²,

Ros³

2004

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Recent technologic advances have significantly enhanced the role of imaging in the detection, characterization, and management of infectious diseases involving the liver. In addition, imaging-guided percutaneous drainage has greatly improved the clinical treatment of patients with focal liver abscess. Infectious liver diseases can be accurately evaluated with ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging. Characteristic changes in US echogenicity, CT attenuation, or MR imaging signal intensity and typical enhancement patterns can contribute to the diagnosis of specific infectious diseases, including abscesses, parasitic diseases, fungal diseases, granulomatous diseases, viral hepatitis, and other less common infections. CT is particularly helpful in revealing the presence of calcifications and gas and in detailing the enhancement pattern. The multiplanar capability of MR imaging and its sensitivity to small differences in tissue composition increase its specificity for certain hepatic infections, including hydatid cyst and candidiasis. Radiologic findings may be sufficient to obviate aspiration or histologic examination, although in most instances they are less specific. Nevertheless, imaging findings taken together with appropriate clinical information may provide the most likely diagnosis, even if biopsy is sometimes required for confirmation.

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Section: Candidiasismentioning

confidence: 99%

The Infected Liver: Radiologic-Pathologic Correlation

Mortelé¹,

Segatto²,

Ros³

2004

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212

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“…The diagnosis may be difficult because blood cultures may be negative and the symptoms non-specific [15]. …”

Section: Discussionmentioning

confidence: 99%

Imaging features of fungal infection in immuno-suppressed patients in a local ward outbreak

Sarji

Abdullah²,

Wastie³

2006

Biomed. Imaging Interv. J.

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Purpose of studyTo examine the role of imaging in diagnosing and assessing fungal infections in paediatric patients undergoing chemotherapy in a facility, which had high fungal air contamination due to adjacent building construction work.Materials and methodNineteen patients aged five months to 12 years with various malignancies, mainly leukaemia, along with probable fungal infection were referred for imaging over a period of 12 months. The imaging findings from their CT and chest radiographs were reviewed by two radiologists and correlated with the clinical findings. Blood culture and/or biopsy of relevant lesions were performed for all patients.ResultsFungus was positively isolated in 11 out of 19 patients, but the remaining patients clinically had fungal infection. The most common species isolated was Candida sp. (five patients), followed by Aspergillus sp. The most common site of fungal infection was the lungs (10 out of 19 patients), where consolidation or cavitating nodules were seen on CT or the plain chest radiograph. One patient developed pulmonary artery aneurysm as a complication. The other sites affected were the intra-abdominal organs (liver, kidneys, and spleen) and the paranasal sinuses, shown on CT. Two patients with clinical evidence of infection and Candida sp. isolated from their blood, however, showed no abnormal findings on imaging.ConclusionEarly diagnosis of fungal infections in oncology patients undergoing chemotherapy is important, but diagnosis may be difficult through imaging because of the non-specific changes and the presence of abnormalities from the underlying disease. Even if a specific diagnosis cannot be reached, imaging is useful to monitor response to treatment and detect complications.

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Liver

Ertürk¹,

Ichikawa²

2016

Teaching Atlas of Hepatobiliary and Pancreatic Imaging

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Hepatic abscesses in the immunocompromised patient: Role of CT in detection, diagnosis, management, and follow-up

Cited by 21 publications

References 23 publications

The Infected Liver: Radiologic-Pathologic Correlation

The Infected Liver: Radiologic-Pathologic Correlation

Imaging features of fungal infection in immuno-suppressed patients in a local ward outbreak

Liver

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