Keywords
pyogenes
antibiotic
drainage
surgery
prognosis Introduction Observations Patient 1
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Abstract
Introduction :
The liver abscess is a rare and serious condition. The aim of this study was to describe the management of 2 cases of pyogenic liver abscess and to review the literature.
Case Reports :
Two patients, aged 33 and 52 years, with a history of biliary peritonitis operated 5 months ago for the first one and a chronic wound soiled by animal droppings for the second one. They were admitted to the National Hospital of Zinder (NHZ) for right hypochondrium pain associated with an infectious syndrome. The clinical examination revealed in both patients a painful and febrile hepatomegaly with Fontan's triad. Imaging examinations evoked the diagnosis of hepatic abscesses. The pus puncture identified a gram-negative bacillus of the genus Escherichia Coli in the first patient and a gram-positive cocci of the genus Streptococcus Bovis in the second. The treatment was based on antibiotic therapy and iterative puncture aspirations, the first patient required surgical drainage under general anesthesia. The evolution was favorable and the second patient was discharged without complications. The youngest patient presented a biliary leak in the postoperative period, which was drained for 2 months.
Conclusion :
Pyogenic liver abscess is rare in our context, the positive diagnosis is made by imaging and pus puncture. The medical treatment is based on an adapted antibiotic therapy and iterative punctures. Surgery is still appropriate in complicated forms that do not respond to simple puncture.
References
1. Lafont E, Rossi G, Rossi B, Roux O, de Lastours V, Zarrouk V, et al. Abcès du foie. J Anti-Infect. 2017;19(3):89‑99.
2. Rossi G, Lafont E, Gasperini L, Dokmak S, Ronot M, Rossi B, et al. Abcès hépatiques. Rev Med Interne. 2016;37(12).
3. Chiche L, Dargère S, Le Pennec V, Dufay C, Alkofer B. Abcès à pyogènes du foie. Diagnostic et prise en charge. Gastroenterol Clin Biol. 2008;32(12):1077‑91.
4. Lardière-Deguelte S, Ragot E, Amroun K, Piardi T, Dokmak S, Bruno O, et al. Hepatic abscess: Diagnosis and management. J Visc Surg. 2015;152(4):231‑43.
5. Khim G, Em S, Mo S, Townell N. Liver abscess: diagnostic and management issues found in the low resource setting. Br Med Bull. 2019;132(1).
6. Diallo VMPC, Déguénonvo LF, Manga NM, Ka D, Diop SA, Seck A, et al. Characteristics of Liver Abscess in Department of Infectious Diseases at Fann Teaching University Hospital in Dakar, Senegal. Adv Infect Dis. 19 janv 2018;8(1):23‑31.
7. Zeevaert JB, Wain E, Louis E, Dorthu L, Meurisse N, Moerman F. Abcès du foie: A propos d'un cas et revue de la littérature. Rev Med Liege. 2020; 75(11): 731-7.
8. Shi Sh, Zai Zl, Zheng Ss. Pyogenic Liver Abscess of Biliary Origin: The Existing Problems and Their Strategies. Semin Liver Dis. 2018;38(3).
9. Dieng M, Diop B, Konate I, Ka O, Dia A, Toure CT. Traitement des abcès du foie: l’expérience d’un service de chirurgie générale. Med Afr Noire. 2007;54(10):513‑9.
10. Develoux M, Niel G, Lamothe F, Abarchi H, Gautier Y, Cenac A. L’amibiase hépatique à l’hôpital de Niamey. Amibiase Hépat À Hôp Niamey. 1987;80(5):792‑6.
11. Ndong A, Tendeng J, Niang FG, Diao ML, Diedhiou M, Dieng M, et al. Abcès du foie à pyogènes compliqué d’une thrombose cave inférieure et d’une compression des voies biliaires : à propos d’un cas. Rev Afr Chir Spéc. 2019;13(1):31‑4.
12. Dieng M, Diop B, Cissé M, Konaté I, Ka O, Dia A, et al. Drainage des abcès du foie par la technique de<< l’hépatotomie à minima>>. Médecine Trop. 2009;35(5):475.
13. Bougossa E, Aouam A, Marrakchi W, Kooli I, A. Toumi A, C. Loussaief C et al. Abcès hépatique à pyogènes chez le diabétique : à propos de 6 cas. Annales d’Endocrinologie. 2020;81:408–456
14. Ibara JR, Ollandzobo Ikobo LC, Atipo Ibara BI, Itoua Ngaporo A. Abcès du foie a germes pyogènes aspects cliniques, morphologiques et étiologiques à propos de 38 cas. Médecine D’Afrique Noire. 2000;47:92‑6.
15. Halim A, Bassène ML, Diallo S, Thioubou MA, Gueye MN, Fall MP, et al. Aspects actuels de l’amibiase hépatique à Dakar. A propos de 48 observations. J Afr HépatoGastroentérologie. déc 2016;10(4):170‑5.
16. Mischnik A, Kern WV, Thimme R. [Pyogenic liver abscess: Changes of Organisms and Consequences for Diagnosis and Therapy]. Dtsch Med Wochenschr 1946. 2017; 142(14): 1067-74.
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Copyright (c) 2021 I Amadou Magagi, M Doutchi, H Adamou, M Abdoulaye, I Hamidine, O Adakal, K Ganiou, M Hassan, L James Didier, R Sani