A Case of Pyogenic Liver Abscess Caused by Staphylococcus epidermidis in a Healthy Child

건강한 소아에서 발생한 Staphylococcus epidermidis에 의한 화농성 간농양 1례

  • Gwak, Ji Hye (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Eem, Yeun Joo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Choi, Ui Yoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 곽지혜 (가톨릭대학교 의과대학 소아과학교실) ;
  • 임연주 (가톨릭대학교 의과대학 소아과학교실) ;
  • 최의윤 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Received : 2012.09.09
  • Accepted : 2012.10.18
  • Published : 2013.04.25

Abstract

Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring $7.0{\times}6.5$ cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.

간농양은 선진국과 개발도상국에서 발생빈도에 차이가 있는 질환으로 국내에서는 드물다. 면역결핍, 간, 담도계기형, 천공성 충수염, 외상, 단백질 결핍 등의 선행요인이 있을 때 발생하기 쉬우며 Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus, Bacteroides와 Entamoeba histolytica 등에 의해 유발된다. 저자들은 발열을 주소로 내원한 건강한 12세 남아에서 컴퓨터 단층촬영을 시행하여 간농양을 발견하였으며 경피배액술 흡인물 배양 검사에서 Staphylococcus epidermidis가 검출되어 항생제를 투여하여 합병증 없이 치료하였기에 보고한다.

Keywords

References

  1. Lee SB, Hwang KS, Cho KS, Moon DS. A case of pyogenic abscess with fever of unknown origin. J Korean Pediatr Soc 1983;26:1145-8.
  2. Byun JL, Bae SH, Park SW. A case of liver abscess in a 10-year-old girl. Korean J Pediatr 2010;53:666-8. https://doi.org/10.3345/kjp.2010.53.5.666
  3. Mishra K, Basu S, Roychoudhury S, Kumar P. Liver abscess in children: an overview. World J Pediatr 2010;6:210-6. https://doi.org/10.1007/s12519-010-0220-1
  4. Sharma MP, Kumar A. Liver abscess in children. Indian J Pediatr 2006;73:813-7. https://doi.org/10.1007/BF02790392
  5. Johannsen EC, Sifri CD, Madoff LC. Pyogenic liver abscesses. Infect Dis Clin North Am 2000;14:547-63. https://doi.org/10.1016/S0891-5520(05)70120-3
  6. Salahi R, Dehghani SM, Salahi H, Bahador A, Abbasy HR, Salahi F. Liver abscess in children: a 10-year single centre experience. Saudi J Gastroenterol 2011;17:199-202. https://doi.org/10.4103/1319-3767.80384
  7. Hansen PS, Schonheyder HC. Pyogenic hepatic abscess. A 10-year population-based retrospective study. APMIS 1998;106:396-402. https://doi.org/10.1111/j.1699-0463.1998.tb01363.x
  8. Kliegman RM. Liver abscess. In: Kliegman RM, Stanton BF, Schor NF, Behrman RE, St. Geme III JW, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier Saunders, 2011:1404-5.
  9. Muorah M, Hinds R, Verma A, Yu D, Samyn M, Mieli- Vergani G, et al. Liver abscesses in children: a single center experience in the developed world. J Pediatr Gastroenterol Nutr 2006;42:201-6. https://doi.org/10.1097/01.mpg.0000189344.23387.26
  10. Hendricks MK, Moore SW, Millar AJ. Epidemiologocal aspects of liver abscess in children in the Western Cape Province of South Africa. J Trop Pediatr 1997;43:103-5. https://doi.org/10.1093/tropej/43.2.103
  11. Pineiro-Carrero VM, Andres JM. Morbidity and mortality in children with pyogenic liver abscess. Am J Dis Child 1989;143:1424-7.
  12. Ferreira MA, Pereira FE, Musso C, Dettogni RV. Pyogenic liver abscess in children; some observations in the Espirito Santo State, Brazil. Arq Gastroenterol 1997;34:49-54.
  13. Kumar A, Srinivasan S, Sharma AK. Pyogenic liver abscess in children-South Indian experiences. J Pediatr Surg 1998;33:417-21. https://doi.org/10.1016/S0022-3468(98)90081-1
  14. Todd JK. Coagulase-negative staphylococci. In: Kliegman RM, Stanton BF, Schor NF, Behrman RE, St. Geme III JW, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier Saunders, 2011:909-10.
  15. Israeli R, Jule JE, Hom J. Pediatric pyogenic liver abscess. Pediatr Emerg Care 2009;25:107-8. https://doi.org/10.1097/PEC.0b013e318196fa9b
  16. Donovan AJ, Yellin AE, Ralls PW. Hepatic abscess. World J Surg 1991;15:162-9. https://doi.org/10.1007/BF01659049
  17. Barakate MS, Stephen MS, Waugh RC, Gallagher PJ, Solomon MJ, Storey DW, et al. Pyogenic liver abscess: a review of 10 year's experience in management. Aust N Z J Surg 1999;69:205-9 https://doi.org/10.1046/j.1440-1622.1999.01523.x