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Purpose: Liver abscesses concomitant with acute prostatitis are rare and potentially fatal. We analyzed the occurrence of this condition and clinical characteristics of the affected patients. Materials and Methods: The medical records of 474 patients diagnosed with acute prostatitis between June 2006 and July 2022 were retrospectively reviewed. Patients in whom pathogens were not detected in serum or urine cultures were excluded. A total of 271 patients were included in the analysis. Patient characteristics and laboratory test results were compared between patients with acute prostatitis with and without liver abscesses. Results: Fifteen patients (5.5%) were identified with simultaneous liver abscesses and acute prostatitis. The liver abscess group was younger than the non-liver abscess group in terms of mean age. In the univariate analysis, a high proportion of patients had diabetes mellitus, whereas a low proportion had hypertension. None of the underlying diseases, including benign prostatic hyperplasia, malignancy, or alcoholism, demonstrated a significant association with liver abscess in multivariate analysis; however, an association was observed in liver function test results. All patients with liver abscesses tested positive for Klebsiella pneumoniae. Conclusions: When K. pneumoniae is identified in patients with acute prostatitis and abnormal liver function tests, considering the possibility of metastatic infection in other organs, including the liver, and performing an active evaluation is essential. [ABSTRACT FROM AUTHOR]

Fusobacterium nucleatum is a commensal pathogen typically found in the oral cavity, digestive tract, and urogenital system which has been associated with Lemierre's syndrome, periodontal diseases, sinusitis, endocarditis, and intra-abdominal and brain abscesses. Our case is of a 62-year-old male who presented with headaches, nausea, and vision loss. Brain imaging identified a right occipito-parietal brain abscess. Following surgery and abscess drainage, Fusobacterium nucleatum was isolated from intraoperative cultures, and the infectious disease service was consulted for antibiotic recommendations. Additional history uncovered that he had also been experiencing night sweats, generalized weakness and 40-pound weight loss for 2 months, and had a prior history of colon polyps and diverticulitis. Furthermore, the patient disclosed having substandard oral hygiene practices, particularly in relation to the care of his dental appliances. Despite negative blood cultures, suspicion for hematogenous seeding was high. Imaging ruled out periodontal disease, but identified a colovesical fistula and liver abscesses, indicating potential translocation of bacteria via portal circulation to his liver. Echocardiogram workup revealed a 1-cm mobile vegetation on the aortic valve. His course was complicated by breakthrough seizures, renal failure, and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, and he ultimately completed 16 weeks of antibiotics. This case illustrates an uncommon presentation of brain abscess in an immunocompetent adult, with a prior episode of diverticulitis as the probable primary infection source, leading to development of a colovesical fistula and bacterial dissemination to the liver, heart, and brain. It highlights the importance of a comprehensive diagnostic approach, including consideration of atypical pathogens in immunocompetent adults. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae invasive syndrome (KPIS) is characterized by primary pyogenic liver abscess associated with metastatic infections. Although rare, Klebsiella endocarditis carries a high mortality risk. Case presentation: A 60-year-old lady with type II diabetes mellitus presented with fever, malaise, right hypochondriac pain and vomiting for two weeks. Ultrasound abdomen revealed a collection within liver, and distended gallbladder with echogenic debris within. 3 days after ultrasound guided pigtail drainage of gallbladder empyema, newly presence murmur detected. Pus, urine, and blood cultures obtained were positive for Klebsiella pneumonia. Echocardiogram exhibited oscillating mass attached to anterior mitral valve leaflet. After 6 weeks of intravenous ceftriaxone, follow-up echocardiogram and ultrasound showed complete resolution of mitral valve vegetation, hepatic and gallbladder collection. Conclusion: Concomitant extrahepatic infective endocarditis (IE) should raise concerns in daily practice for patients with Klebsiella pneumoniae liver abscesses, despite the rarity of Klebsiella endocarditis. In the absence of diagnostic suspicion, antibiotic treatment regimens may be shortened, and adverse effects from IE infection may ensue. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Accidental foreign body ingestion is the most common hidden cause of abdominal pain. A high index of suspicion should be implemented in patients with unresolved abdominal pain. Here we reported a 54‐year‐old patient with vague abdominal pain who had a successful laparoscopic removal of a toothpick. Toothpicks and fish bones are considered one of the most common accidentally ingested foreign bodies. Fortunately, most patients are asymptomatic. About 80%–90% of ingested foreign bodies pass through the gut spontaneously within a week. We present a case of a 54‐year‐old female with chronic epigastric pain and fever found to have a foreign body (toothpick) that penetrated the stomach and migrated to the liver causing liver abscess with portal vein thrombosis. The patient was managed with laparoscopic removal of the foreign body with an uneventful postoperative course. [ABSTRACT FROM AUTHOR]

Background: K. pneumoniae liver abscess (KPLA) mostly involves the right lobe. We present a case of K. pneumoniae caudate liver abscess with invasive liver abscess syndrome (ILAS) was rarely identified. Case presentation: A 53-year-old man with elevated glycated hemoglobin with chills, rigors and a fever of five days. The patient presented with tachycardia and fever. Physical examination revealed tenderness over the right abdomen was elicited. In particular, the inflammatory markers were markedly elevated, and computerized tomography (CT) showed pulmonary abscess, pulmonary embolism and caudate liver abscess. The patient's sequential organ failure assessment (SOFA) score was 10 points. Klebsiella pneumoniae was isolated from sputum, urine and blood. With the suspicion of liver abscesses, ILAS and sepsis. The patient was successfully treated with antibiotics. He returned to close to his premorbid function. Conclusion: K. pneumoniae caudate liver abscess was rare. This is the first detailed report of K. pneumoniae caudate liver abscess with invasive liver abscess syndrome. Patients with cryptogenic K. pneumoniae liver abscess are advised to undergo an examination of intestinal barrier function. The study indicates that in patients with K. pneumoniae liver abscess, a caudate liver abscess size of ≤ 9.86 cm² may be characteristic of those suitable for conservative treatment of invasive liver abscess syndrome. [ABSTRACT FROM AUTHOR]

Objective：By analyzing the clinical characteristics of septic shock in patients of pyogenic liver abscess complicated with diabetes, we explored the early risk factors for shock prediction. Methods：We collected the clinical data of 240 diabetic patients with liver abscesses assessed by computerized tomography（CT）in the First Affiliated Hospital of Nanjing Medical University from January 2017 to April 2021. According to whether septic shock occurred or not during hospitalization, these patients were divided into a shock group and a non⁃shock group. The general information of patients at the first visit, symptoms, basic vital signs, abdominal CT and blood biochemical indicators, etc. were analyzed to identify the risk factors of shock. Results：①Comparing the general data of two groups, there was a significant difference in age（P < 0.05). ②There were significant differences in respiratory rate, heart rate and maximum body temperature between the two groups of patients（P < 0.05), and the differences in mean arterial pressure and CT manifestations of absess were not statistically significant between two groups（P > 0.05). ③Compared with the non ⁃ shock group, the white blood cell count and neutrophil count in the shock group were significantly increased, but the platelet count was significantly decreased. ④The prothrombin time, international standardized ratio of prothrombin time, partial thromboplastin activation time, and thrombin time were significantly prolonged in the shock group compared with the non ⁃shock group（P < 0.05). ⑤The binary logistic regression analysis showed that respiratory rate, maximum body temperature and prothrombin time were independent predictors of septic shock. Conclusion：The respiratory rate, maximum body temperature and prothrombin time of patients at the first diagnosis may provide important predictive value for the early identification of shock in patients with pyogenic liver abscess complicated with diabetes. [ABSTRACT FROM AUTHOR]

Amebic liver abscesses should be considered in adult males with a liver abscess and a history of travel to endemic areas. Effective treatment includes metronidazole, followed by paromomycin.

Introduction: The aim of this study was to describe a very rare case of endogenous bacterial endophthalmitis caused by Klebsiella pneumoniae in both eyes with a difference in the onset of symptoms of 14 months in an immunocompetent patient. Case Presentation: A 66-year-old immunocompetent man presented with asynchronous bilateral endogenous endophthalmitis produced by the K. pneumoniae bacterium at the starting point of a liver abscess after cholecystectomy surgery, causing endophthalmitis 1 year and 2 months apart between an eye and another. The first was diffuse anteroposterior endophthalmitis in the left eye that ended in visual loss and phthisis bulbi due to delayed initial diagnosis and established treatment, and the second was focal endophthalmitis in the right eye that preserved the organ and resulted in a vision of 20/20 due to early suspected diagnosis and rapid instituted treatment. Conclusion: To our knowledge, this is the first published case of a long asynchronous bilateral endogenous bacterial endophthalmitis caused by K. pneumoniae with a prolonged difference of 14 months in the onset of symptoms between one eye and another. This case is a vision-threatening ophthalmologic emergency that can be associated with life-threatening systemic morbidities. The early diagnosis of infection represents a challenge for clinicians, ophthalmologists, and microbiologists.

Abstract Background Klebsiella pneumoniae invasive syndrome (KPIS) is characterized by primary pyogenic liver abscess associated with metastatic infections. Although rare, Klebsiella endocarditis carries a high mortality risk. Case presentation A 60-year-old lady with type II diabetes mellitus presented with fever, malaise, right hypochondriac pain and vomiting for two weeks. Ultrasound abdomen revealed a collection within liver, and distended gallbladder with echogenic debris within. 3 days after ultrasound guided pigtail drainage of gallbladder empyema, newly presence murmur detected. Pus, urine, and blood cultures obtained were positive for Klebsiella pneumonia. Echocardiogram exhibited oscillating mass attached to anterior mitral valve leaflet. After 6 weeks of intravenous ceftriaxone, follow-up echocardiogram and ultrasound showed complete resolution of mitral valve vegetation, hepatic and gallbladder collection. Conclusion Concomitant extrahepatic infective endocarditis (IE) should raise concerns in daily practice for patients with Klebsiella pneumoniae liver abscesses, despite the rarity of Klebsiella endocarditis. In the absence of diagnostic suspicion, antibiotic treatment regimens may be shortened, and adverse effects from IE infection may ensue.

Abstract Background K. pneumoniae liver abscess (KPLA) mostly involves the right lobe. We present a case of K. pneumoniae caudate liver abscess with invasive liver abscess syndrome (ILAS) was rarely identified. Case presentation A 53-year-old man with elevated glycated hemoglobin with chills, rigors and a fever of five days. The patient presented with tachycardia and fever. Physical examination revealed tenderness over the right abdomen was elicited. In particular, the inflammatory markers were markedly elevated, and computerized tomography (CT) showed pulmonary abscess, pulmonary embolism and caudate liver abscess. The patient’s sequential organ failure assessment (SOFA) score was 10 points. Klebsiella pneumoniae was isolated from sputum, urine and blood. With the suspicion of liver abscesses, ILAS and sepsis. The patient was successfully treated with antibiotics. He returned to close to his premorbid function. Conclusion K. pneumoniae caudate liver abscess was rare. This is the first detailed report of K. pneumoniae caudate liver abscess with invasive liver abscess syndrome. Patients with cryptogenic K. pneumoniae liver abscess are advised to undergo an examination of intestinal barrier function. The study indicates that in patients with K. pneumoniae liver abscess, a caudate liver abscess size of ≤ 9.86 cm² may be characteristic of those suitable for conservative treatment of invasive liver abscess syndrome.

A woman in her 50s presented to the emergency department with 5 days of abdominal pain, nausea and vomiting. CT imaging of her liver demonstrated three enhancing, cystic lesions in her hepatic parenchyma and a large enhancing lesion in her porta hepatis concerning for a hepatic artery aneurysm. Radiographic-guided drainage was performed on two accessible liver abscesses, and cultures from this drainage grew Listeria monocytogenes Serial imaging of the aneurysm demonstrated that the aneurysm spontaneously thrombosed and did not require further intervention. She was subsequently discharged on intravenous ampicillin with a plan to continue until radiographic resolution of the abscesses.

A 57-year-old male veteran presented to the emergency department for recurrent fevers for 10 days. The patient was febrile but had an overall benign physical exam. This interesting case explores the broad differential diagnosis and evaluation in a patient who presents with fever of unknown origin.

Abstract Liver abscess is endemic in resource-limited countries such as The Gambia where access to advanced imaging techniques or modern treatment modalities is limited. Despite this, mortality in this cohort was low. Therefore antibiotic therapy combined with percutaneous abscess drainage remains a reasonable treatment strategy of liver abscess in resource-poor settings.

Non-hormone-treated beef steers (n = 1625; 371 ± 8.4 kg) were used to determine the impact of a direct-fed microbial (DFM) on growth performance, carcass characteristics, health parameters, and economic outcomes in finishing beef cattle. Steers were blocked based on initial BW, sorted into three optimal marketing groups for each day of enrollment, randomly assigned to one of two treatments (12 replicates per treatment), and fed for an average of 133 days before harvest. Treatments included the following: (1) control (CON) and (2) 50 mg/head per day of a DFM (BDP) containing Lactobacillus animalis 506, Propionibacterium freudenreichii 507, Bacillus licheniformis 809, and Bacillus subtilis 597 (BOVAMINE DEFEND® Plus). Steers were weighed in drafts by pen on a certified scale at closeout, and both pens within a block were harvested on the same day. Carcass characteristics and liver scores were collected upon slaughter. Data were analyzed as part of a completely randomized block design with the pen as the experimental unit. There was no difference in dry matter intake and final body weight between treatments. The BDP steers exhibited a lower number of total outs (deads and removed) throughout the experiment (p < 0.01). Average daily gain (ADG) tended to be greater (p < 0.06), and feed efficiency (p < 0.01) was greater, for steers receiving BDP. Although there were no statistical differences in hot carcass weight and quality grade between treatments, there was a lower incidence of liver abscess scores (p < 0.01) in the BDP steers. These data suggest that BOVAMINE DEFEND® Plus supplementation improves growth performance during the finishing phase, reduces overall mortality, and improves feed to gain efficiency.

Abstract Liver abscess is a potentially life-threatening medical emergency. Prompt empirical antimicrobial with or without percutaneous aspiration or drainage is therapeutic. The rational for using empirical intravenous broad-spectrum antimicrobials upfront instead of oral Fluoroquinolone or Cephalosporin is contentious. In this double blind randomized control clinical trial 69 participants received Ciprofloxacin (500 mg q 12 hourly) and 71 participants received Cefixime (200 mg q 12 hourly) orally for 2 weeks. Both the group received oral Metronidazole (800 mg q 8 hourly) for 2 weeks and percutaneous drainage or aspiration of the abscess was done as per indication and followed-up for 8 weeks. Out of 140 participants, 89.3% (N = 125) achieved clinical cure, 59 (85.5%) in Ciprofloxacin group and 66 (93%) in Cefixime group (p = 0.154). Mean duration of antimicrobial therapy was 16.2 ± 4.3 days, 15.1 ± 4.5 days in Ciprofloxacin group and 16.0 ± 4.2 days in Cefixime group (p = 0.223). Total 15 (10.7%) participants had treatment failure, 10 (14.5%) in Ciprofloxacin group and 5 (7.0%) in Cefixime group (p = 0.154). The most common reason for treatment failure was need of prolong (> 4 weeks) antimicrobial therapy due to persistent hepatic collection requiring drainage, which was significantly (p = 0.036) higher in Ciprofloxacin (14.5%, N = 10) group, compared to the Cefixime (4.2%, N = 3) group. In conclusion, both, the Ciprofloxacin or Cefixime plus Metronidazole for duration of 2–3 weeks were efficacious as empirical oral antimicrobial regimen along with prompt percutaneous drainage or aspiration for the treatment of uncomplicated liver abscess with similar efficacy. Oral Cefixime was better than Ciprofloxacin in term of lesser chance of treatment failure due to persistent collection which is required to be investigated further in larger clinical trial. Trial registration: clinicaltrials.gov PRS ID: NCT03969758, 31/05/2019.

Objective : To explore the risk factors of sepsis caused by liver abscess, and to construct a nomogram prediction model based on the Prognostic Nutrition Index (PNI) and systemic immune inflammation index (SII).Methods : We retrospectively .selected 215 patients who were admitted to the Second Affiliated Hospital of Hainan Medical University from January 2021 to December 2023 who were diagnosed with bacterial liver abscess. They were divided into group (h=71 cases) and non - sepsis group (h=144 cases) sepsis according to whether they developed sepsis. The clinical data of the patients were collected and compared. The patient's PNI value and SII value was calculated, and the best boundary value of sepsis in patients with liver abscess was predicted by drawing a receiver operating characteristic (ROC) curve, and it was converted into a binary variable; univariate analysis and multivariate logistic regression analysis was used to select independent predictors of sepsis in patients with liver abscess and a nomogram prediction model was constructed; the prediction model was evaluated by further drawing the area under the ROC curve (AUC), calibration curve and decision curve analysis (DCA) of the prediction model. Results: Among the 215 patients with bacterial liver abscess, 70 cases (70/215) did not undergo liver abscess puncture, 8 cases (8/215) underwent puncture culture but the etiology was negative, and 137 cases (137/215) underwent puncture culture and the etiology was positive.) ; including 114 cases of Klebsiella pneumoniae (114/137), which was the most common strain in patients with liver abscess in this study; through ROC curve analysis, the AUC of PNI in diagnosing sepsis in patients with liver abscess was 0.760 (95% CI: 0.697~0.816), the sensitivity and specificity are 0.803, 0.681 (P<0.05) respectively; the AUC of SII is 0.7,56, (9,5% CI: 0.693~0.812), the sensitivity and specificity are 0.732, 0.722 (P<0.05); the study showed through single-factor and multi-factor logistic regression analysis that there were 6 independent predictors of sepsis in patients with liver abscess (all P<0.05), including gender, PCT, PNI, SII, treatment method, diabetes, the nomogram model constructed with the above 6 predictors predicts the risk of sepsis in patients with liver abscess. The nomogram ROC curve analysis results show that the AUC of the model are 0.886 (95%CI: 0.837~0.934), and the corresponding sensitivity and specificity are 0.845 and 0.806, respectively. Conclusion: Klebsiella pneumoniae is the most common type of liver abscess. Diabetes, biliary tract disease, elevated PCT value, and elevated SII are risk factors for sepsis in patients with liver abscess. Anti-infection combined with abscess puncture and drainage and elevated PNI value a protective factor for patients. The nomogram prediction model constructed based on this study has good accuracy, calibration, and clinical practicability for patients with liver abscess complicated by sepsis. [ABSTRACT FROM AUTHOR]

Simple Summary: Scientific research and industry support for DFMs have been growing steadily, with studies consistently demonstrating their ability to improve nutrient digestibility and overall performance in beef and dairy cattle. By combining different bacterial strains, DFMs can enhance immune response, increase feed efficiency, and improve carcass characteristics in beef cattle. Lactobacillus and Baciillus strains have emerged as popular choices for their beneficial effects on ruminal fermentation, stability, and enzymatic activity. These bacteria improve cattle's nutrient digestion and overall performance. A novel DFM mixture called BOVAMINE DEFEND® Plus, containing a combination of L. animalis 506, P. freudenreichii 507, B. licheniformis 809, and B. subtilis 597, has shown promising results in improving beef cattle health and performance and a reduction in liver abscesses. BOVAMINE DEFEND® Plus shows multifaceted benefits that suggest the potential to revolutionize livestock agriculture by promoting economic viability and animal health within a probiotic. Continued research efforts will shed more light on the broader implications of this novel DFM mixture, shaping the future of sustainable and efficient beef production practices. Non-hormone-treated beef steers (n = 1625; 371 ± 8.4 kg) were used to determine the impact of a direct-fed microbial (DFM) on growth performance, carcass characteristics, health parameters, and economic outcomes in finishing beef cattle. Steers were blocked based on initial BW, sorted into three optimal marketing groups for each day of enrollment, randomly assigned to one of two treatments (12 replicates per treatment), and fed for an average of 133 days before harvest. Treatments included the following: (1) control (CON) and (2) 50 mg/head per day of a DFM (BDP) containing Lactobacillus animalis 506, Propionibacterium freudenreichii 507, Bacillus licheniformis 809, and Bacillus subtilis 597 (BOVAMINE DEFEND® Plus). Steers were weighed in drafts by pen on a certified scale at closeout, and both pens within a block were harvested on the same day. Carcass characteristics and liver scores were collected upon slaughter. Data were analyzed as part of a completely randomized block design with the pen as the experimental unit. There was no difference in dry matter intake and final body weight between treatments. The BDP steers exhibited a lower number of total outs (deads and removed) throughout the experiment (p < 0.01). Average daily gain (ADG) tended to be greater (p < 0.06), and feed efficiency (p < 0.01) was greater, for steers receiving BDP. Although there were no statistical differences in hot carcass weight and quality grade between treatments, there was a lower incidence of liver abscess scores (p < 0.01) in the BDP steers. These data suggest that BOVAMINE DEFEND® Plus supplementation improves growth performance during the finishing phase, reduces overall mortality, and improves feed to gain efficiency. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) stands as a significant contributor to cancer-related mortality globally. While the acute and often fatal manifestations of locally advanced HCC primarily present within the abdomen, it is crucial to recognize that the respiratory and circulatory systems can also fall victim due to the liver's unique anatomical position within the body. Here, we present the case of a 63-year-old male recently diagnosed with locally advanced HCC with vascular invasion. Shortly after receiving target therapy and focal radiotherapy, the patient developed repeated secondary infections and a persistent diaphragmatic defect. As the necrotic tissue invaded the pleural space, subsequent tumor-to-bronchial and tumor-to-cardiac fistulas emerged, resulting in an abnormal connection between the respiratory and cardiovascular systems, leading to massive air emboli in circulation. This report highlights the risk of supradiaphragmatic complications in HCC patients with post-treatment secondary infections, particularly in patients predisposed to developing diaphragmatic defects. [ABSTRACT FROM AUTHOR]

Liver abscess is a potentially life-threatening medical emergency. Prompt empirical antimicrobial with or without percutaneous aspiration or drainage is therapeutic. The rational for using empirical intravenous broad-spectrum antimicrobials upfront instead of oral Fluoroquinolone or Cephalosporin is contentious. In this double blind randomized control clinical trial 69 participants received Ciprofloxacin (500 mg q 12 hourly) and 71 participants received Cefixime (200 mg q 12 hourly) orally for 2 weeks. Both the group received oral Metronidazole (800 mg q 8 hourly) for 2 weeks and percutaneous drainage or aspiration of the abscess was done as per indication and followed-up for 8 weeks. Out of 140 participants, 89.3% (N = 125) achieved clinical cure, 59 (85.5%) in Ciprofloxacin group and 66 (93%) in Cefixime group (p = 0.154). Mean duration of antimicrobial therapy was 16.2 ± 4.3 days, 15.1 ± 4.5 days in Ciprofloxacin group and 16.0 ± 4.2 days in Cefixime group (p = 0.223). Total 15 (10.7%) participants had treatment failure, 10 (14.5%) in Ciprofloxacin group and 5 (7.0%) in Cefixime group (p = 0.154). The most common reason for treatment failure was need of prolong (> 4 weeks) antimicrobial therapy due to persistent hepatic collection requiring drainage, which was significantly (p = 0.036) higher in Ciprofloxacin (14.5%, N = 10) group, compared to the Cefixime (4.2%, N = 3) group. In conclusion, both, the Ciprofloxacin or Cefixime plus Metronidazole for duration of 2–3 weeks were efficacious as empirical oral antimicrobial regimen along with prompt percutaneous drainage or aspiration for the treatment of uncomplicated liver abscess with similar efficacy. Oral Cefixime was better than Ciprofloxacin in term of lesser chance of treatment failure due to persistent collection which is required to be investigated further in larger clinical trial. Trial registration: clinicaltrials.gov PRS ID: NCT03969758, 31/05/2019. [ABSTRACT FROM AUTHOR]

Drug-eluting bead transarterial chemoembolization (DEB-TACE) causes serious complications, including liver abscess and biloma formation. This study aimed to investigate the frequency and risk factors of liver abscess and biloma formation after dug-eluting bead transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma (ICC). 152 unresectable ICC patients received 241 DEB-TACE procedures from February 2018 to November 2022 were studied retrospectively. Patients were evaluated for the presence of liver abscess and biloma formation after DEB-TACE. The medical records, including baseline demographic data, preoperative imaging data, DEB-TACE details, and postoperative management, were reviewed to search for risk factors of liver abscess and biloma formation. Liver abscesses developed in 11 cases, with an incidence rate of 7.2 % (11/152) per patient and 4.6 % (11/241) per procedure. In the 11 patients with abscesses, the incidence of biloma formation was 36.4 % (n = 4). The binary logistic regression analysis showed that diabetes mellitus (OR 7.967, 95 % CI 1.491–42.571, p = 0.015), bilioenterostomy or biliary stent implantation (OR 18.716, 95 % CI 1.006–348.049, p = 0.049) and grade 1 arterial occlusion (OR 9.712, 95 % CI 1.054–89.484, p = 0.045) were independent risk factors for liver abscess and biloma formation. Liver abscesses and biloma formation induced by DEB-TACE are associated with various factors. Diabetes mellitus, bilioenterostomy or biliary stent implantation, and grade 1 artery occlusion were all associated with liver abscess and biloma formation after DEB-TACE for unresectable ICC. In patients with these risk factors, the DEB-TACE procedure should be finely designed and manipulated with more caution. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to investigate the clinical features, incidence, pathogenesis, and management of liver abscess after drug‐eluting bead transarterial chemoembolization (DEB‐TACE) for primary and metastatic hepatic malignant tumors. Methods: From June 2019 to June 2021, patients with liver abscess after DEB‐TACE for primary and metastatic hepatic malignant tumors were reviewed and evaluated at our hospital. Demographic and clinical data, radiological findings, management approaches, and prognosis were retrospectively analyzed. Results: In total, 419 DEB‐TACE procedures were carried out in 314 patients with primary and metastatic liver tumors at our medical center. Twelve patients were confirmed to have liver abscesses after DEB‐TACE through clinical manifestations, laboratory investigations, and imaging. In this study, the incidence of liver abscess was 3.82% per patient and 2.86% per DEB‐TACE procedure. After percutaneous drainage and anti‐inflammatory treatments, 10 patients recovered, and the remaining 2 patients died due to direct complications of liver abscess, such as sepsis and multiple organ failure. The mortality rate of liver abscesses after DEB‐TACE was 16.7% (2/12). Conclusion: The incidence of liver abscess after DEB‐TACE is relatively high and can have serious consequences, including death. Potential risk factors could include large tumor size, history of bile duct or tumor resection, history of diabetes, small DEB size (100–300 μm). Sensitive antibiotics therapy and percutaneous abscess aspiration/drainage are effective treatments for liver abscess after DEB‐TACE. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Despite growing awareness of post-coronavirus disease 2019 (COVID-19) cholangiopathy as one of the most serious long-term gastrointestinal consequences of COVID-19, the endoscopic features of this disease are still poorly characterized. This study aimed tomore precisely define its endoscopic features and to outline the role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of this entity. METHODS: In this observational study, 46 patients with confirmed post-COVID-19 cholangiopathy were included. RESULTS: Based on the endoscopic features observed in 141 ERCP procedures, post-COVID-19 cholangiopathy can be classified as a variant of secondary sclerosing cholangitis in critically ill patients. It appeared early in the course of intensive care treatment of patients with COVID-19 (cholestasis onset 4.5 days after intubation, median). This form of cholangiopathy was more destructive than stricturing in nature and caused irreversible damage to the bile ducts. A centripetal pattern of intrahepatic bile duct destruction, the phenomenon of vanishing bile ducts, the absence of extrahepatic involvement, and the presence of intraductal biliary casts (85% of patients) were typical cholangiographic features of post-COVID-19 cholangiopathy. This cholangiopathy was often complicated by small peribiliary liver abscesses with isolation of Enterococcus faecium and Candida spp. in bile culture. The prognosis was dismal, with a 1-year liver transplantation-free survival rate of 44%. In particular, patients with peribiliary liver abscesses or destruction of the central bile ducts tended to have a poor prognosis (n.s.). As shown by multivariate analysis, bilirubin levels (on intensive care unit day 25-36) negatively correlated with liver transplantation-free survival (hazard ratio 1.08, P < 0.001). Interventional endoscopy with cast removal had a positive effect on cholestasis parameters (gamma-glutamyl transpeptidase, alkaline phosphatase, and bilirubin); approximately 60% of all individual values decreased. DISCUSSION: Gastrointestinal endoscopy makes an important contribution to the management of post-COVID-19 cholangiopathy. ERCP is not only of great diagnostic and prognostic value but also has therapeutic value and therefore remains indispensable. [ABSTRACT FROM AUTHOR]

Liver abscesses (LA) resulting from bacterial infection in cattle pose a significant global challenge to the beef and dairy industries. Economic losses from liver discounts at slaughter and reduced animal performance drive the need for effective mitigation strategies. Tylosin phosphate supplementation is widely used to reduce LA occurrence, but concerns over antimicrobial overuse emphasize the urgency to explore alternative approaches. Understanding the microbial ecology of LA is crucial to this, and we hypothesized that a reduced timeframe of tylosin delivery would alter LA microbiomes. We conducted 16S rRNA sequencing to assess severe liver abscess bacteriomes in beef cattle supplemented with in-feed tylosin. Our findings revealed that shortening tylosin supplementation did not notably alter microbial communities. Additionally, our findings highlighted the significance of sample processing methods, showing differing communities in bulk purulent material and the capsule-adhered material. Fusobacterium or Bacteroides ASVs dominated LA, alongside probable opportunistic gut pathogens and other microbes. Moreover, we suggest that liver abscess size correlates with microbial community composition. These insights contribute to our understanding of factors impacting liver abscess microbial ecology and will be valuable in identifying antibiotic alternatives. They underscore the importance of exploring varied approaches to address LA while reducing reliance on in-feed antibiotics. [ABSTRACT FROM AUTHOR]

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Key Clinical Message Accidental foreign body ingestion is the most common hidden cause of abdominal pain. A high index of suspicion should be implemented in patients with unresolved abdominal pain. Here we reported a 54‐year‐old patient with vague abdominal pain who had a successful laparoscopic removal of a toothpick. Abstract Toothpicks and fish bones are considered one of the most common accidentally ingested foreign bodies. Fortunately, most patients are asymptomatic. About 80%–90% of ingested foreign bodies pass through the gut spontaneously within a week. We present a case of a 54‐year‐old female with chronic epigastric pain and fever found to have a foreign body (toothpick) that penetrated the stomach and migrated to the liver causing liver abscess with portal vein thrombosis. The patient was managed with laparoscopic removal of the foreign body with an uneventful postoperative course.

Introduction: Laparoscopic cholecystectomy is the gold standard in the management of symptomatic gallstones. However, it is estimated that there are 2–15 cases of hepatic abscesses per 100,000 people in the U.S., mostly of bacterial etiology, and approximately half of these are caused by cholangitis. Given the infrequency of cholangitis-induced pyogenic hepatic abscesses and the 0.4 % incidence of choledocholithiasis in post-cholecystectomy patients, pyogenic hepatic abscesses secondary to post-cholecystectomy choledocholithiasis comprise a rare entity. A hepatic abscess occurring post-laparoscopic cholecystectomy is a known complication that can manifest months or even years after the surgery. This case involves a 56-year-old female patient who presented with a 10-day history of abdominal pain and discomfort, primarily in the right hypochondrium, accompanied by fever unresponsive to antibiotics and antipyretics. The appropriate treatment approach was chosen based on clinical signs, abscess size, and the patient's overall condition. Conclusion: This case shows the late complications arising from gallstone spillage into the abdominal cavity during laparoscopic cholecystectomy. It underscores the importance of careful laparoscopic exploration, especially in gallbladder perforation and stone spillage cases. Detailed documentation of the operative procedure is crucial, as it aids in the prophylactic and symptomatic treatment of long-term complications such as abscess formation.

Liver abscess is endemic in resource-limited countries such as The Gambia where access to advanced imaging techniques or modern treatment modalities is limited. Despite this, mortality in this cohort was low. Therefore antibiotic therapy combined with percutaneous abscess drainage remains a reasonable treatment strategy of liver abscess in resource-poor settings. [ABSTRACT FROM AUTHOR]

Introduction: We report the case of a 76-year-old male who was hospitalized with severe dehydration, pain in the hepatic region, and weakness in the limbs. Methodology: A contrast-enhanced abdomen CT and a contrast-enhanced ultrasound identified a large liver abscess. The patient underwent percutaneous drainage of the abscess. Results: The culture examination, analyzed by multiplex polymerase chain reaction test, showed the presence of Klebsiella oxytoca. The laboratory report identified a resistance mechanism involving a plasmid-mediated SHV-1 extended-spectrum-beta-lactamase (ESBL). Conclusions: K. oxytoca is a Gram-negative bacterium and is potentially associated with a large variety of infections. The association between the liver abscess by K. oxytoca and rhabdomyolysis had not yet been described in the literature. [ABSTRACT FROM AUTHOR]

Abstract Amoebic liver abscess is a severe and potentially life-threatening infection requiring prompt diagnosis and early targeted treatment. Diagnosis is challenging because conventional diagnostic methods such as light microscopy and serology are often unreliable. Molecular techniques have emerged as an additional diagnostic tool, suddenly becoming the new diagnostic reference standard. More recently, commercial multiplex PCR panels, including FilmArray, have been introduced, which permit the simultaneous detection of several enteric pathogens including Entamoeba histolytica in stool samples. We report a case of an amoebic liver abscess promptly diagnosed by FilmArray gastrointestinal panel performed on liver drainage fluid.

Abstract Background Aspergillus spp liver abscess is a relatively rare entity and thus far no systematic review has been performed examining patients’ demographics, clinical manifestations, diagnosis, management, and outcome. Methods We performed a systematic review of the literature using MEDLINE and LILACS databases. We searched for articles published in the period from January 1990 to December 24, 2022, to identify patients who developed liver abscesses due to Aspergillus spp. Results Our search yielded 21 patients all of whom had invasive aspergillosis confirmed on liver biopsy. Of these patients 81% were adults, and 60% were males. The majority (86%) of patients were immunocompromised and 95% had symptomatic disease at the time of diagnosis. The most common symptoms were fever (79%), abdominal pain (47%), and constitutional symptoms (weight loss, chills, night sweats, fatigue) (38%). Liver enzymes were elevated in 50%, serum galactomannan was positive in 57%, and fungal blood cultures were positive in only 11%. Co-infection with other pathogens preceded development of apsergillosis in one-third of patients, and the majority of the abscesses (43%) were cryptogenic. In the remaining patients with known source, 28% of patients developed liver abscess through dissemination from the lungs, 19% through the portal vein system, and in 10% liver abscess developed through contiguous spread. The most common imaging modality was abdominal computerized tomography done in 86% of patients. Solitary abscess was present in 52% of patients while 48% had multiple abscesses. Inadequate initial empiric therapy was prescribed in 60% of patients and in 44% of patients definite treatment included combination therapy with two or more antifungal agents. Percutaneous drainage of the abscesses was done in 40% of patients, while 20% required liver resection for the treatment of the abscess. Overall mortality was very high at 38%. Conclusion Further studies are urgently needed for a better understanding of pathophysiology of liver aspergillosis and for developement of newer blood markers in order to expedite diagnosis and decrease mortality.

Introduction: Pyogenic liver abscess is a noteworthy health concern in North America, characterized by a mortality rate ranging from 2 to 12%. This condition is often polymicrobial, with Streptococcus species and Escherichia coli as the predominant causal pathogens in Western countries. Fusobacterium species, typically commensals of gastrointestinal, genital, and oral flora, have been implicated in the rare formation of tonsillar abscesses and Lemierre syndrome, including its gastrointestinal variant known as pylephlebitis. Case Presentation: We present the case of an immunocompetent male with a 2-week history of abdominal distention and pain. Abdominal magnetic resonance imaging revealed multiseptated cystic hepatic masses and portal vein thrombosis. A subsequent liver biopsy confirmed Fusobacterium nucleatum etiology. The patient was initiated on intravenous cefepime and oral metronidazole antibiotics. Unfortunately, the patient succumbed to cardiac arrest before a final diagnosis could be established. Conclusion: Fusobacterium species-associated liver abscess, coupled with the rare gastrointestinal variant of Lemierre syndrome (pylephlebitis), poses a significant mortality risk. This case underscores the rarity and clinical challenges associated with these conditions. Increased awareness among clinicians is crucial for early diagnosis and prompt intervention, potentially improving outcomes in such cases.

Kun Li,1 Dongsheng Han,2 Ahmad Alhaskawi,3 Tingting Liu,1 Xiaojuan Wang,4 Wu Yang,1 Hui Lu,3 Xueling Fang1 1Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University school of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Orthopaedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Clinical Pharmacy, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of ChinaCorrespondence: Xueling Fang, Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79, Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, People’s Republic of China, Fax +86 571-87236838, Email 1191012@zju.edu.cn Hui Lu, Department of Orthopaedics, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79, Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, People’s Republic of China, Fax +86 571-87236121, Email HuiLu@zju.edu.cnBackground: Chromobacterium violaceum (C. violaceum) is a Gram-negative bacterium capable of causing severe infections in both humans and specific animals. Despite its infrequency, C. violaceum infections exhibit a notably high mortality rate. The timely and precise detection of this pathogen stands as a critical factor in achieving effective diagnosis and treatment. Traditional diagnostic approaches possess limitations, particularly in terms of their time-consuming nature and the range of pathogens they can identify. Metagenomic next-generation sequencing (mNGS) testing has emerged as a highly promising diagnostic tool for infectious diseases.Methods: Within this case report, we present a patient who developed a C. violaceum infection subsequent to a lower limb infection, leading to the progression of sepsis, a liver abscess, septic shock, multi-organ dysfunction, and altered mental status. Samples of the patient’s blood and tissue from the lower limb skin are collected, and the infection is swiftly diagnosed through mNGS, allowing for the immediate initiation of suitable treatment.Results: The mNGS results revealed the patient’s infection with C. violaceum. Subsequent conventional bacterial culture results were concordant with the mNGS findings. Following comprehensive management measures, including prompt and effective anti-infective treatment, the patient achieved cure and was successfully discharged.Conclusion: This case underscores the significance of employing advanced diagnostic methodologies like mNGS for the early detection of uncommon pathogens such as C. violaceum. The expedited diagnosis and timely intervention hold the potential to substantially enhance patient outcomes in cases of severe infections instigated by this bacterium.Keywords: chromobacterium violaceum, sepsis, infection, hepatapostema, liver, liver abscess, metagenomic next-generation sequencing

Objective To investigate the ocular clinical features and diagnostic and therapeutic protocol of patients with endogenous endophthalmitis (EE) secondary to Klebsiella pneumoniae liver abscess (KPLA). Methods Six patients (seven eyes) with EE secondary to KPLA who attended our hospital from January 2019 to December 2020 were enrolled and analyzed in terms of clinical manifestation, examination findings, treatment regimen, and prognosis. Results All six patients were male, among whom five had pyrexia. All patients had impaired vision, and at initial diagnosis, there were four patients (five eyes) with no light perception, one patient (one eye) with manual vision, and one case (one eye) with light perception. All patients had the typical clinical manifestations of endophthalmitis such as impaired vision, conjunctival congestion and edema, ocular swelling and pain, and inflammatory response in the anterior chamber, and postoperative microbial culture of intraocular fluid showed positive Klebsiella pneumoniae. At the last visit, four patients (four eyes) had loss of vision, one patient (one eye) did not cooperate in vision check, and one patient (two eyes) was lost to follow-up. Conclusion EE secondary to KPLA is highly destructive to eyeball structure and visual function, and patients with KPLA who develop systemic symptoms (such as fever) or ocular discomfort (such as loss of vision, eye redness, and eye pain) should attend the outpatient service of ophthalmology department and receive regular follow-up examination to be alert to the development of endophthalmitis.

Liver abscess is a common disease, however, it is a rare cause of venous thrombosis. The incidence of amoebic and pyogenic liver abscess in developing countries is high, however, the occurrence of inferior vena cava thrombosis secondary to liver abscess is a very rare and life-threatening complication. Computed tomography (CT) scan is an ideal investigation tool for diagnosing the various complications associated with liver abscess. Here we describe 3 cases of liver abscess in patients who developed a rare vascular complication of inferior vena cava. Liver abscesses should be considered as a rare cause of IVC thrombosis in the correct clinical context. All the patients were managed with ultrasound-guided pigtail insertion and antimicrobial agents.

Background: Aspergillus spp liver abscess is a relatively rare entity and thus far no systematic review has been performed examining patients' demographics, clinical manifestations, diagnosis, management, and outcome. Methods: We performed a systematic review of the literature using MEDLINE and LILACS databases. We searched for articles published in the period from January 1990 to December 24, 2022, to identify patients who developed liver abscesses due to Aspergillus spp. Results: Our search yielded 21 patients all of whom had invasive aspergillosis confirmed on liver biopsy. Of these patients 81% were adults, and 60% were males. The majority (86%) of patients were immunocompromised and 95% had symptomatic disease at the time of diagnosis. The most common symptoms were fever (79%), abdominal pain (47%), and constitutional symptoms (weight loss, chills, night sweats, fatigue) (38%). Liver enzymes were elevated in 50%, serum galactomannan was positive in 57%, and fungal blood cultures were positive in only 11%. Co-infection with other pathogens preceded development of apsergillosis in one-third of patients, and the majority of the abscesses (43%) were cryptogenic. In the remaining patients with known source, 28% of patients developed liver abscess through dissemination from the lungs, 19% through the portal vein system, and in 10% liver abscess developed through contiguous spread. The most common imaging modality was abdominal computerized tomography done in 86% of patients. Solitary abscess was present in 52% of patients while 48% had multiple abscesses. Inadequate initial empiric therapy was prescribed in 60% of patients and in 44% of patients definite treatment included combination therapy with two or more antifungal agents. Percutaneous drainage of the abscesses was done in 40% of patients, while 20% required liver resection for the treatment of the abscess. Overall mortality was very high at 38%. Conclusion: Further studies are urgently needed for a better understanding of pathophysiology of liver aspergillosis and for developement of newer blood markers in order to expedite diagnosis and decrease mortality. [ABSTRACT FROM AUTHOR]

Amoebic liver abscess is caused by Entamoeba histolytica infection, which manifests as invasive extraintestinal amoebiasis and is often found in tropical countries including Indonesia. Amoebic liver abscess contributes to 50,000 deaths globally. Establishing the diagnosis requires liver imaging and serological tests. The detection of Entamoeba histolytica parasite is crucial in determining the etiology of amoebic liver abscess. The aim of this study is to report a case of a 20-year-old male with symptoms of right upper abdominal pain, fever, nausea, and anorexia, and to evaluate the effectiveness of laparoscopic abscess drainage as a treatment method. The method used is clinical data analysis and therapy outcome evaluation. The results show that the patient experienced clinical improvement after treatment with metronidazole and laparoscopic abscess drainage, with no additional physical complications. Entamoeba histolytica is an amoeba transmitted through the fecaloral route and enters the bloodstream, subsequently forming abscesses in the liver. The patient presented with a large liver abscess and required operative drainage. Amoebic liver abscess generally responds well to medical treatment. However, in certain cases such as large abscess sizes, percutaneous drainage is needed to prevent abscess rupture. The patient was managed with laparoscopic drainage, which resulted in fewer physical injuries. Proper management can prevent complications from liver abscess rupture. [ABSTRACT FROM AUTHOR]

Liver abscess is commonly seen but liver abscess with caecal gangrene or perforation is a very rare condition. The peritonitis due to caecal perforation when associated with liver abscess is commonly misdiagnosed as ruptured liver abscess and during surgical intervention is often overlooked which comes out to be detrimental. Entamoeba histolytica commonly invades the mucosa of caecum which causes flask shaped ulcers leading to fulminant typhilitis to caecal perforation. Here we describe six cases of concomitant liver abscess with cecal gangrene. Caecal perforation with liver abscess is rare but fatal condition which requires high degree of suspicion for diagnosis as the early intervention is prerequisite for better outcome. [ABSTRACT FROM AUTHOR]

A 76‐year‐old man underwent an operation for lung squamous cell carcinoma in the right lower lobe, followed by initial adjuvant therapy with atezolizumab, an antibody against anti‐programmed death‐ligand 1 (PD‐L1). On day 4 after atezolizumab treatment, the patient developed general malaise and fatigue. He was diagnosed with atezolizumab‐induced sclerosing cholangitis. Steroid treatment was started, and patient's condition, including symptoms, laboratory data and imaging findings, improved. Antibiotic treatments were ended on day 40, and the steroid dose was gradually reduced. Multiple liver abscesses were observed on day 106, and another treatment with antibiotics became necessary. The patient eventually recovered from liver abscesses. Sclerosing cholangitis induced by immune checkpoint inhibitor is rare, and the long‐term clinical data about this adverse effect is limited. Hence, we think it is important to raise an alarm over sclerosing cholangitis coupled with liver abscesses after immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Amoebic liver abscess is a severe and potentially life-threatening infection requiring prompt diagnosis and early targeted treatment. Diagnosis is challenging because conventional diagnostic methods such as light microscopy and serology are often unreliable. Molecular techniques have emerged as an additional diagnostic tool, suddenly becoming the new diagnostic reference standard. More recently, commercial multiplex PCR panels, including FilmArray, have been introduced, which permit the simultaneous detection of several enteric pathogens including Entamoeba histolytica in stool samples. We report a case of an amoebic liver abscess promptly diagnosed by FilmArray gastrointestinal panel performed on liver drainage fluid. [ABSTRACT FROM AUTHOR]

The objective was to evaluate the replacement of barley-based ingredients with short-season high-moisture corn products on steer growth performance and carcass characteristics. Over 2 years, 320 beef steers (528�±�36.2�kg initial body weight) were assigned to 32 pens (4 pens/treatment/year). Treatments were finishing diets that contained dry-rolled barley grain and barley silage (BGBS; control), barley grain and corn silage (BGCS), high-moisture shelled corn and barley grain with barley silage (HCBS), or snaplage (included as a silage and grain source) with barley grain (SNAP). Steers were fed for 99 days and 72 days in years 1 and 2, respectively. Steers fed BGCS did not differ (P�≥�0.13) from BGBS for dry matter intake, average daily gain, gain:feed, or carcass characteristics. Steers fed HCBS had greater (P�≤�0.05) hot carcass weight and dressing percentage than BGBS. A lesser (P�=�0.02) proportion of steers fed SNAP had severe liver abscesses than BGBS. We concluded that corn silage can replace barley silage, 50% replacement of barley grain with high-moisture shelled corn may improve hot carcass weight, and replacement of barley silage and some barley grain with snaplage decreases the proportion of cattle with severe liver abscesses at slaughter. [ABSTRACT FROM AUTHOR]

Hypervirulent Klebsiella pneumoniae (hvKP) causes multisite infections and abscesses. However, endocarditis is a rare presentation of hvKP infection. Herein, we report a case of K. pneumoniae native valve infective endocarditis secondary to community-acquired liver and prostate abscesses. The patient developed papillary muscle rupture, leading to mitral regurgitation, and underwent emergent mitral valve replacement. The diagnosis of endocarditis was confirmed microbiologically and histologically. The causative strain belonged to the hypermucoid K1 capsular genotype and possessed the rmpA gene. The genome sequence was deposited in GenBank under the accession number JAQZBZ000000000. [ABSTRACT FROM AUTHOR]

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The presence of bacteria in the bloodstream is associated with severe clinical outcomes. In mice, intravenous inoculation of Escherichia coli can lead to the formation of macroscopic abscesses in the liver. Abscesses are regions of severe necrosis and consist of millions of bacteria surrounded by inflammatory immune cells. Liver abscess susceptibility varies widely across strains of mice, but the host factors governing this variation are unknown. Here, we profiled hepatic transcriptomes in mice with varying susceptibility to liver abscess formation. We found that transcripts from endogenous retroviruses (ERVs) are robustly induced in the liver by E. coli infection and ERV expression positively correlates with the frequency of abscess formation. Hypothesizing that ERV-encoded reverse transcriptase may generate cytoplasmic DNA and heighten inflammatory responses, we tested whether nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) influence abscess formation. Strikingly, a single NRTI dose administered immediately following E. coli inoculation prevented abscess formation, leading to a concomitant 100,000-fold reduction in bacterial burden. We provide evidence that NRTIs inhibit abscess formation by preventing the tissue necrosis that facilitates bacterial replication. Together, our findings suggest that endogenous reverse transcriptases drive inflammatory responses during bacterial bloodstream infection to drive abscess formation. The high efficacy of NRTIs in preventing abscess formation suggests that the consequences of reverse transcription on inflammation should be further examined, particularly in infectious diseases where inflammation drives negative clinical outcomes, such as sepsis. [ABSTRACT FROM AUTHOR]

Introduction: Pyogenic liver abscess is a noteworthy health concern in North America, characterized by a mortality rate ranging from 2 to 12%. This condition is often polymicrobial, with Streptococcus species and Escherichia coli as the predominant causal pathogens in Western countries. Fusobacterium species, typically commensals of gastrointestinal, genital, and oral flora, have been implicated in the rare formation of tonsillar abscesses and Lemierre syndrome, including its gastrointestinal variant known as pylephlebitis. Case Presentation: We present the case of an immunocompetent male with a 2-week history of abdominal distention and pain. Abdominal magnetic resonance imaging revealed multiseptated cystic hepatic masses and portal vein thrombosis. A subsequent liver biopsy confirmed Fusobacterium nucleatum etiology. The patient was initiated on intravenous cefepime and oral metronidazole antibiotics. Unfortunately, the patient succumbed to cardiac arrest before a final diagnosis could be established. Conclusion:Fusobacterium species-associated liver abscess, coupled with the rare gastrointestinal variant of Lemierre syndrome (pylephlebitis), poses a significant mortality risk. This case underscores the rarity and clinical challenges associated with these conditions. Increased awareness among clinicians is crucial for early diagnosis and prompt intervention, potentially improving outcomes in such cases. [ABSTRACT FROM AUTHOR]

BACKGROUND: Liver abscess is a common clinical problem in tropical countries and is most commonly caused by pyogenic, amoebic or mixed infections. Abscess is usually suspected clinically in cases having fever, tender hepatomegaly and the diagnosis is usually confirmed on the basis of imaging such as ultrasound and computerized tomography. Management includes antimicrobial agents and drainage of abscess. Percutaneous drainage (PD) of abscess is done using needle aspiration or by pigtail catheter drainage. AIMS AND OBJECTIVE: To evaluate the role of ultrasound guided pigtail catheterization drainage procedure as a treatment option in cases of liver abscess. MATERIALS AND METHODS: It was a prospective study conducted at the Radiology department of Bolan Medical Complex Hospital, Quetta, Pakistan from August 2021 to September 2022. Forty eight patients diagnosed as hepatic abscess were included in this study on the basis of predefined inclusion and exclusion criteria. These patients underwent pigtail catheterization of liver abscess as a part of their treatment. The patients included in the study were diagnosed with liver abscess by ultrasound and CT and were treated in coordination with surgery department. The effectiveness of pigtail drainage was evaluated by doing serial ultrasound scans. The demographic characteristics, hepatic lobe involvement, amount of pus drained and complications were studied in these patients. RESULTS: Out of 48 patients, 32 were male and 16 were female with a M: F ratio of 2:1. The age ranged from 10 years to 70 years. The mean age of the study cases was found to be 35-40 years. Right lobe was involved in predominant cases. Eight patients developed procedure related complications out of which 3 had catheter blockage, 2 patients had catheter dislodgment requiring repositioning, 2 patient developed pus discharge from catheter site and remaining 1 patient developed subcapsular hematoma. Average hospital stay varied from 2 5 days. No major complications reported during the procedure. CONCLUSION: Percutaneous ultrasound guided pigtail catheter is an effective minor invasive procedure as a treatment option for liver abscess with high success rate and no procedure related mortality. [ABSTRACT FROM AUTHOR]

Aspirates of liver abscess are frequently encountered in routine practice and are often of a low index of suspicion. However, necrotic liver metastasis clinically and radiologically mimics liver abscesses, and malignant cells can be obscured in an inflammation‐rich background on cytology. It is important to recognise malignant neoplasms in this scenario, in particular uncommon conditions such as metastatic mucosal melanoma. [ABSTRACT FROM AUTHOR]

Background and objective: To research the prevalence of hepatic abscesses at our facility. To examine the Age and Sex distribution. to examine the clinical characteristics based on variations in symptoms and symptomatology. To determine the disease's microbiology. To shed light on the role that radiological imaging plays in making a diagnosis and organising treatment appropriately. to classify the disease's mode of therapy. Method: On 100 patients who were enrolled in the trial throughout the time, a study was conducted at Department of General Surgery, Deccan College of Medical Sciences, Hyderabad, Telangana, India from to December 2022 to October 2023. Ultrasonography was used to confirm the clinical diagnosis of hepatic abscess in these patients. Result: Men are more common than women. 6:1 ratio; 5 th decade is peak incidence. Eighty four percent of cases had alcohol as the cause. The most prevalent clinical features are abdominal pain (96%) and soreness (72%), with the typical mode of presentation being observed in 81% of patients. Sixty five percent of cases had a right lobe abscess. Aspiration is the most often used therapeutic method (45%). Conclusion: According to an ultrasound, the abscess in the current study had completely disappeared after three to four months; in our series, individuals with lower socioeconomic status account for roughly 70% of all abscesses examined. [ABSTRACT FROM AUTHOR]

Abstract A man in his 70s on maintenance dialysis for autosomal dominant polycystic kidney disease was admitted with epigastralgia and a fever lasting for 1 week. Computed tomography showed a thickened liver cyst measuring 121 mm in the caudate lobe, suggesting infection. Percutaneous drainage was impossible because multiple liver cysts and ascites entered the puncture route. Endoscopic ultrasound (EUS) revealed a huge liver cyst with debris‐like echoes. Transgastric EUS‐guided drainage was performed, and internal and external drainage was performed without adverse events. After the procedure, the symptoms quickly improved, and the external drain was removed after 12 days. The internal drainage stent remained in place, and the patient was discharged from the hospital 53 days after the EUS‐guided drainage. EUS‐guided drainage is an effective alternative treatment for infected liver cysts where a percutaneous approach is impossible.

Gas-forming pyogenic liver abscess (GFLPA) carries a high mortality rate. Early identification of the source of infection in sepsis results in better survival. Bedside point of care ultrasound (POCUS) can be used to help localize a source of infection. A 59-year-old man presented with systemic inflammatory response syndrome (SIRS) and was diagnosed with GFLPA on the initial encounter via clinical assessment and POCUS examination. After commencing antibiotics, optimal glucose control, adequate fluid resuscitation, and early infective source control, he achieved full recovery and was followed up in outpatient medical and surgical clinics. This case illustrates the role of POCUS as a diagnostic tool in sepsis and raises awareness among clinicians to recognize the features of GFLPA on POCUS.