• Pediatric Infection and Vaccine
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• v.20 no.1
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• pp.36-40
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• 2013

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.

• Neonatal Medicine
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• v.15 no.1
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• pp.105-110
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• 2008

Neonatal liver abscesses are rare, carry a high mortality rate, and are difficult to diagnose. The diagnosis of liver abscesses in the neonate cannot be established from the clinical presentation alone. Risk factors for liver abscesses in neonates are maternal infection, sepsis, umbilical venous catheterization, omphalitis, and necrotizing enterocolitis. In this report, we describe a preterm infant (32 weeks, 1,580 g) who presented with abdominal distension, respiratory difficulties, and a persistent inflammatory response in spite of broad spectrum antibiotic treatment; a large (6${\times}$5 cm) solitary pyogenic liver abscess was identified at 9 days of age. It appeared that the liver abscess had originated in the uterus and umbilical venous catheterization facilitated its spread. Percutaneous drainage under abdominal ultrasound guidance was performed and prolonged antibiotics were treated for 5 weeks, effecting a cure.

• Korean Journal of Veterinary Research
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• v.48 no.1
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• pp.119-124
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• 2008

A castrated male, 4-year old, Dachshund weighing 5.3 kg with an acute history of anorexia, vomiting, severe depression, and hypothermia for 1 day was referred. Severe leukopenia, mild increased hepatic enzymes, and mild imbalanced electrolyte were found on laboratory tests. There are no remarkable findings on abdominal radiographs. Ultrasonography showed multifocal heterogeneous and hypoechoic round regions in the liver. Ultrasound guided fine needle aspiration and drainage were performed and hepatic abscess was diagnosed. The patient was recovered normally without any complications through aggressive medical treatments from the result of culture and sensitivity test.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.57-60
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• 2003

A 4 year old female with acute lower abdominal pain was admitted with the diagnosis of periappendiceal abscess made by ultrasonography. At laparotomy, the appendix was normal, but the left ovary was twisted and necrotic. Appendectomy and left salpingo-oophorectomy were performed. The pathology of the appendix was normal, and the left tube and ovary were ischemic and had hemorrhagic necrosis. Pediatric adnexal torsion may be difficult to diagnosis clinically. Sonography is the preferred imaging study. It usually confirms a pelvic mass but may not establish the diagnosis. The correct diagnosis of adnexal torsion is often made at exploration. The most common erroneous diagnosis is acute appendicitis or periappendiceal abscess. Therapy for adnexal torsion remains controversial. While extirpation has been the standard of treatment in the past, there are current proponents of conservative therapy with adnexal sparing. Early diagnosis may lead to more frequent salvage of affected adnexa.

• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.168-172
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• 2021

Retroperitoneal infections are rarer than intra-abdominal infections in children; however, they can lead to significant morbidity in cases of missed diagnosis. We present a case of retroperitoneal abscess caused by extended-spectrum β-lactamase-producing Escherichia coli in a 10-year-old female adolescent who failed to show clinical improvement following empirical antibiotic therapy.

• Journal of Gastric Cancer
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• v.15 no.4
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• pp.262-269
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• 2015

Purpose: Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. Materials and Methods: We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. Results: The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. Conclusions: This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.165-172
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• 2023

Pyogenic liver abscess is a rare condition in healthy children in developed countries, but it can have severe consequences if diagnosis and treatment are delayed. Staphylococcus aureus is the most commonly identified cause of pyogenic liver abscess worldwide, while Klebsiella pneumoniae is the predominant causative agent in Korea. However, cases of pyogenic liver abscess caused by anaerobic bacteria have also been rarely reported. A 14-year-old boy presented to the emergency room with fever and pain in the upper right abdomen. He exhibited tenderness in the right upper quadrant, elevated white blood cell count, anemia, and elevated liver enzyme levels. Abdominal computed tomography with contrast revealed pyogenic liver abscess. The patient underwent percutaneous catheter drainage for two weeks and received a 4-week course of antibiotic therapy. Prevotella intermedia, an anaerobic bacterium commonly found in the oral flora, was isolated from the drained pus. However, no evidence was found suggesting that the infection originated from a dental source. This case highlights the importance of considering the possibility of pyogenic liver abscess even in otherwise healthy children.

• Childhood Kidney Diseases
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• v.16 no.1
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• pp.58-62
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• 2012

Urinary tract infection (UTI) is most commonly diagnosed bacterial infection in febrile infants. Renal abscess is a very rare complication of UTI in children. Early diagnosis and treatment with appropriate antibiotics are important because renal scar correlates positively with the time of treatment. Renal ultrasonography and abdominal computerized tomography facilitates an earlier diagnosis and is also useful in establishing percutaneous drainage. Extended broad spectrum antibiotics therapy alone can be effective in most types of renal abscesses in infant, but some antibiotics-resistant cases need surgical drainage or nephrectomy. We report a case of a infant UTI, that progressed to renal abscess despite early antibiotic treatment and was treated with US guided percutaneous needle aspiration.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.108-111
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• 2004

Tuberculosis is not a common cause of liver abscess and it is rarely considered in the differential diagnosis of a patient with hepatic mass. We report a case of tuberculous abscess of liver and spleen in a 15-year-old boy who presented with abdominal pain, fever and weight loss. The ultrasonographic and computed tomographic scan of the abdomen revealed multiple cystic lesions in the liver and spleen. Mycobacterium tuberculosis was cultured from the ascitic fluid and biopsy specimen of lymph node. Follow up CT scan of the abdomen after anti-tuberculosis medication for eighteen months showed complete resolution of the cystic lesions with calcified nodules.

• Clinical and Experimental Pediatrics
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• v.56 no.9
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• pp.407-410
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• 2013

Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.