Methicillin resistant Staphylococcus aureus liver abscess related with colorectal cancer (original) (raw)
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Community-Acquired Methicillin-Resistant Staphylococcus Aureus Hepatic Liver Abscess
Cureus, 2021
A methicillin-resistant Staphylococcus aureus (MRSA) liver abscess is a rare infection that if not recognized, and treated early, can be fatal. There is limited literature demonstrating possible etiologies of MRSA liver abscesses, whether nosocomial or community acquired. We present a case of a 45-year-old Guyanese male with a 30 pack-year smoking history. The patient presented with both generalized abdominal pain and a productive cough on two separate occasions. Laboratory results in his second presentation revealed leukocytosis with increased alanine transaminase (ALT). Imaging revealed a multiloculated abscess in the inferior aspect of the liver, measuring 5.1 cm x 3.4 cm x 4 cm, and chest X-ray revealed developing consolidation within the right perihilar region. The patient underwent percutaneous liver drainage via pigtail catheter. Fluid cultures grew MRSA. The patient was placed on vancomycin for three weeks. On subsequent examinations, there was a resolution of leukocytosis w...
An Unusual Case of Pyogenic Liver Abscess Caused by Community-acquired Methicillin-Resistant Staphylococcus aureus
Hepatic abscesses are the most common type of visceral abscesses. The annual incidence is estimated at 2.3 cases per 100,000 people and is more common in men than women. A considerable proportion of pyogenic liver abscesses are caused by hepatobiliary pathologies. However, it may also result from hematogenous seeding from the systemic circulation. Most pyogenic liver abscesses are polymicrobial in nature consisting of anaerobic and enteric gram-negative bacilli species. Less than 10% of cases are caused by Staphylococcus aureus. Of these, few are caused by Methicillin-resistant Staphylococcus aureus (MRSA) and even fewer from the community-acquired strain. The clinical manifestations of pyogenic liver abscesses usually include fever, abdominal pain and non-specific symptoms like nausea, vomiting, malaise, anorexia and weight loss. Treatment of pyogenic liver abscesses consists of source control with drainage and antibiotic therapy tailored to the isolated causative organism. We present a case of a 51-year-old Caucasian man who presented with severe right upper quadrant abdominal pain of 5 days in duration. Abdominal Computed Tomography (CT) showed a 7.7 by 6.0 centimeter multi-loculated mass in the right hepatic lobe with other scattered foci throughout the liver. The abscess was aspirated with a pigtail drain placed under CT guidance. The aspirated culture grew MRSA sensitive to Doxycycline and Trimethoprim/Sulfamethoxazole.
Community-Acquired Methicillin-Resistant Pyogenic Liver Abscess
Journal of Investigative Medicine High Impact Case Reports, 2016
Pyogenic liver abscesses are rare with an incidence of 0.5% to 0.8% and are mostly due to hepatobiliary causes (40% to 60%). Most are polymicrobial with less than 10% being caused by Staphylococcus aureus. Of these, few are caused by methicillin-resistant Staphylococcus aureus (MRSA) and fewer still by a community-acquired strain. Here we present a case study of a patient with a community-acquired MRSA liver abscess. The patient presented with fever since 1 month and tender hepatomegaly. Blood tests revealed elevated levels of alkaline phosphatase, C-reactive protein, erythrocyte sedimentation rate, and neutrophilic leukocytosis. Blood cultures were sterile. Ultrasound of the abdomen showed multiple abscesses, from which pus was drained and MRSA isolated. Computed tomography of the abdomen did not show any source of infection, and an amebic serology was negative. The patient was started on vancomycin for 2 weeks, following which he became afebrile and was discharged on oral linezolid for 4 more weeks. Normally a liver abscess is treated empirically with ceftriaxone for pyogenic liver abscess and metronidazole for amebic liver abscess. However, if the patient has risk factors for a Staphylococcal infection, it is imperative that antibiotics covering gram-positive organisms be added while waiting for culture reports.
Journal of Crohns & Colitis, 2011
Liver abscesses are very rare complications of ulcerative colitis, with only nine cases described in the literature, to our knowledge. We report a case where a recurrence of liver abscess occurred in an ulcerative colitis patient, in two different hepatic lobes, which has not been previously described. The recurrence was in the caudate lobe having the cultures yielded Staphylococcus aureus. This is also the first case report of liver abscess in this location and caused by this microorganism in an ulcerative colitis patient. A review of the literature concerning liver abscesses involving ulcerative colitis patients is also provided.
Liver abscess: demographic, clinical, biochemical, imaging and microbial spectrum
International Journal of Research in Medical Sciences
Background: Liver abscesses are localized suppurative destruction of liver tissue due to infections of either bacterial (Pyogenic) or protozoa (Amoebic). Historically; pyogenic liver abscess has been described since the time of hippocrates (400 BC). Despite the more aggressive approach to treatment, the mortality rate remained at 60-80%.Methods: This Cross-sectional analytical study carried out at Department of Medicine, Al-Tibri Medical College Hospital, Karachi, from June 2017 to December 2018. All participants of either gender with diagnosis of liver abscess were included in this prospective study. Patients with co morbidities like malignancy, autoimmune disease or on immunosuppressive treatment for any reason were excluded from the study. Following confirmation of the diagnosis; different characteristics of either type of liver abscess like demographic, clinical features, biochemical and imaging findings were evaluated.Results: Data of 73 subjects, 65(89.0%) males and 08(11.0%) ...
Prostatic abscess is traditionally considered a rare disease that is caused by Gram-negative bacteria. Methicillin resistant Staphylococcus aureus (MRSA) has recently emerged as an important cause of prostatic abscesses. Symptoms are nonspecific and include dysuria, urinary frequency, fever, chills, and perineal and low back pain. Morbidity and mortality increase with delays in identification and proper treatment. We present two cases of community acquired MRSA prostatic abscesses with bacteremia. One of these cases may be the first reported septic shock fatality resulting from a prostatic abscess source in an immunocompetent patient. As the number of community acquired MRSA bacteremia cases increases, this potential site of infection should be recognized.
BJSTR, 2022
Pyogenic liver abscess (PLA) is an important neglected global health threat during the COVID-19 pandemic and emerged non-communicable diseases. This study aims to investigate the causality and anti-biotic resistance in patients with PLA in Vietnam. Clinical features and treatment outcomes of 96 patients with PLA in Bach Mai Hospital from January 2015 to December 2020 were examined. The laboratory and radiological features, microbiological isolates in blood and pus cultures, antibiotics, and the interpretation of the drug sensitivity tests were performed. Demographic and clinical characteristics, treatment outcomes, and management of these patients were evaluated.
Liver abscess: A retrospective analysis
Indian Journal of Case Reports, 2018
Liver abscess (LA) is defined as a collection of purulent material in the liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. Here, we report a retrospective analysis with an aim to evaluate the clinical presentation, etiology, manifestations, comorbidities, and different treatment options in patients with LA. This retrospective study was conducted to collect and analyze information from patients diagnosed with LA who were admitted to a tertiary care academic hospital.
A Cross Sectional Descriptive Study of Etiology and Clinical Pattern of Liver Abscess : 50 Cases
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2013
Background: The liver is the organ most subjected to the development of abscesses and made up 48 % of all visceral abscesses' and 7% of all intra abdominal abscesses. Liver abscess should be suspected when there is a combination of fever, leucocytosis, constitutional symptoms, and pain in the right upper quadrant, and tenderness over the liver or right lower rib cage. The liver is affected by a number of local and disseminated infections; their frequency and types vary considerably around the world. Parasitic disorders are more prevalent in developing countries. Methods: It was a cross-sectional descriptive study. The cases were taken from the admitted patients of Medicine unit of SMCH, Chittagong. The study was conducted over a period of one year with a sample size of 50 patients and sample was taken by purposive sampling. Results: Among 50 patients 40 (80%) were diagnosed as ALA and 10 (20%) were diagnosed as PLA. ALA cases are common in 21-30 years age group & PLA cases are more common in >50 years of age group. Majority of the cases were from rural area. Common clinical features were fever, abdominal pain, nausea and tender hepatomegaly. Diarrhea was present on admission in 7 (15.9%) patients of ALA. Anaemia was common in both but polymorphonuclear leucocytosis was moderate to severe in PLA. Microscopic examination of stool samples for E. Histolytica trophozoites was positive in 3 (7.5%) cases and cysts in 4(10%) cases. Nine patients had right sided pleural effusion. Conclusions: Clinical features are common in both ALA and PLA. Liver abscesses are more common in men and more prevalent in rural areas. ALA more commonly occurs in 21-30 years age group but can occur at any age. Pyogenic abscess is more common in older age group (>50 years) and E. Coli is the commonest organism.
Methicillin-Resistant Staphylococcus aureus: Fatal Prostatic Abscess in an AIDS Patient
Southern Medical Journal, 2008
Staphylococcus aureus is a known major cause of foodbome illnesses, and raw milk and dairy products are often contaminated by enterotoxigenic and antimicrobial-resistant S. aureus strains. In the present study, 35 S. aureus strains were isolated from 383 raw milk samples collected from various dairy herds in the province of Milan (northern Italy). The isolates were characterized based on their antimicrobial susceptibility patterns and the presence of genes encoding staphylococcal enterotoxins (sea, seb, sec, sed, and see). About half (45.7%) of the strains were enterotoxigenic, and 37.1% were resistant to at least one of the antimicrobial drugs tested. Seven (20%) of 35 isolates were identified as methicillin-resistant S. aureus (MRSA), and SCC mec typing performed with a multiplex PCR assay revealed the presence of gene cassettes IV and V, typical of communityacquired MRSA, and I and II, characteristic of health care-associated MRSA. The MRSA strains were evaluated for the presence of the Panton-Valentine leukocidin gene, but this gene was not found. The results of the present study revealed the presence of toxin-producing S. aureus and MRSA strains in raw milk. MRSA and enterotoxigenic S. aureus in dairy farms are an important risk factor for the spread of staphylococcal infections; therefore, further studies are needed to find strategies for monitoring and controlling the presence of S. aureus, especially MRSA, in dairy products.