Infectious Hepatic Cyst: An Underestimated Complication

Morii, Kazuhiko; Yamamoto, Tetsuya; Nakamura, Shinichiro; Okushin, Hiroaki

doi:10.2169/internalmedicine.0511-17

Cited by 9 publications

(12 citation statements)

References 34 publications

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“…Diagnosing IHCs is challenging due to the difficulty in detecting the location of infections. IHCs are more often found in women than in men, with an estimated female-to-male ratio of 1-1.5:1 [ 1 ]. Symptoms include fever, chills (50%), and abdominal pain (41.7%) [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Superficial infectious liver cysts can cause abdominal pain [3]. Furthermore, when patients have multiple liver cysts and infections, identification of the location of infection among the cysts can be challenging [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Diagnosing infectious hepatic cysts (IHCs) can be challenging, and patients with IHCs may present with various symptoms. The typical symptoms include fever and abdominal pain; however, there could be other symptoms depending on the location of the infection [ 1 ]. Previous studies have shown that infection of liver cysts in the central part of the liver can cause vague symptoms, such as fever and fatigue [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The typical symptoms include fever and abdominal pain; however, there could be other symptoms depending on the location of the infection [ 1 ]. Previous studies have shown that infection of liver cysts in the central part of the liver can cause vague symptoms, such as fever and fatigue [ 1 , 2 ]. Superficial infectious liver cysts can cause abdominal pain [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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The Persistent Approach to Diagnose Infectious Hepatic Cysts in a Patient With Recurrent Fever: A Case Report

Ikeda¹,

Ohta²,

Nishikura³

et al. 2022

Cureus

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Diagnosing infectious hepatic cysts (IHCs) can be challenging. Moreover, patients with IHCs may present with various symptoms. Diagnosis of IHCs can be even more difficult in patients with multiple liver cysts. For appropriate diagnosis, the detection of infectious sections in the liver is essential. However, diagnosing and determining definite treatments for patients with IHCs can be particularly challenging when they have polycystic liver disease. We present a case of a 70-year-old man who visited a rural community hospital with a primary complaint of recurrent fever and pain in the right upper quadrant. Based on his clinical history, physical examination findings, and imaging findings after three admissions, he was diagnosed with IHCs. This case demonstrates the challenges in diagnosing IHCs in patients with multiple hepatic cysts and highlights the necessity of a careful follow-up of clinical histories and findings of definitive imaging tests in the diagnosis of IHCs in patients with recurrent fever. To diagnose IHCs effectively, a comprehensive approach including history taking, physical examination, and diagnostic testing, is essential. IHCs should be considered by physicians when patients present with recurrent fever. To avoid missing IHCs, physicians in outpatient departments should continuously follow up on patients' IHC-related symptoms such as fever and right upper quadrant pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Persistent Approach to Diagnose Infectious Hepatic Cysts in a Patient With Recurrent Fever: A Case Report

Ikeda¹,

Ohta²,

Nishikura³

et al. 2022

Cureus

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“…In the literature, there are some case reports but we could not find any specific information about the exact prevalence for patients who do not suffer from ADPKD. Thus, it seems that this complication is underestimated (6).…”

Section: Case Reportmentioning

confidence: 99%

Infected hepatic cyst complicating urinary sepsis

Coulon¹,

Ould-Nana²,

Wilputte³

2021

AGEB

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Congenital hepatic cysts are a common disorder. Usually they are asymptomatic and do not have to be treated. However, some serious complications can occur. We report here the case of an 86-year old patient who has been treated by a percutaneous drainage for an infected solitary hepatic cyst due to urinary sepsis. She was admitted to the Department of Internal Medicine for epigastric pain with fever and chills. The patient was treated for a urinary tract infection 3 weeks ago by her General Practitioner. On admission, blood tests showed 21 620 neutrophils per microliter with a C-reactive protein level at 443.7 mg/L, procalcitonin > 200 ng/mL, total bilirubin at 1.43 mg/dL, lactate dehydrogenase at 666 U/L and alanine aminotransferase at 227 U/L. Urinalysis and hemocultures highlighted the presence of Escherichia coli and Streptococcus constellatus. The abdominal tomodensitometry indicated the pre-sence of a left hepatic biliary cyst with banal appearance. She was first treated with intravenous amoxicillin clavulanic acid. After a few days, another abdominal tomodensitometry with contrast pinpointed a large abscess of 11 centimeters in diameter extending to liver segments II and IV with a similar small lesion in segments IV and V. clindamycin per os was added to the treatment because of its good diffusion in tissues. Percutaneous drain was inserted under tomodensitometric control and stayed in place until the follow-up at three weeks. Bacteriologic culture on the fluid sample demonstrated the presence of Escherichia coli and Streptococcus constellatus. The abscess completely regressed after 6 weeks of treatment and the biologic abnormalities resolved at the same time.

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Infected liver cysts resulting from ascending cholangitis and cancer of the ampulla of Vater: A case report

Hsu

Tsai

Chen

et al. 2021

Adv in Digestive Medicine

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Infected liver cysts may have a unique etiology and require further workup. Generally, large cyst is easy to be symptomatic. In contrast, smaller cyst with infection in our case is associated with ampullar cancer of Vater without typical manifestations of jaundice, body weight loss, and pancreatitis. We presented the case of a 61‐year‐old man with infected liver cysts, which is confirmed by abdominal computer tomography and liver cysts drainage with bacterial culture. Endoscopic retrograde cholangiopancreatography revealed a swollen papilla of Vater and a dilated common bile duct. Biopsy confirmed adenocarcinoma of the ampulla of Vater. Further surgical pathology revealed communication of bile duct with liver cysts and no evidence of tumor invasion to pancreatic duct and common bile duct. The infected liver cysts may result from ascending cholangitis which is secondary to ampullar cancer. The patient underwent the Whipple procedure, unroofing of the right‐side liver cyst, and partial hepatectomy without complications. There is no recurrence of infected liver cyst and cancer till now after follow‐up for 3 years. Infected liver cysts are rarely associated with ampullar cancer. Early diagnosis and successful resection of early stage ampullary neoplasm ensure favorable outcomes.

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Infectious Hepatic Cyst: An Underestimated Complication

Cited by 9 publications

References 34 publications

The Persistent Approach to Diagnose Infectious Hepatic Cysts in a Patient With Recurrent Fever: A Case Report

The Persistent Approach to Diagnose Infectious Hepatic Cysts in a Patient With Recurrent Fever: A Case Report

Infected hepatic cyst complicating urinary sepsis

Infected liver cysts resulting from ascending cholangitis and cancer of the ampulla of Vater: A case report

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