Abstract

FYNN, Estefanía; MACHADO, Karina; ACOSTA, Alex  and  GUTIERREZ, Stella. Pyogenic liver abscess in pediatrics: a difficult to diagnose clinical case. Arch. Pediatr. Urug. [online]. 2019, vol.90, n.3, pp.53-62.  Epub June 01, 2019. ISSN 0004-0584.  https://doi.org/10.31134/ap.90.2.5.

Liver abscess (LA) is a rare but well-defined child pathology that requires an accurate, adequate and early diagnosis and treatment, in order to prevent further morbidity and mortality. The clinical symptoms are not specific. In most cases, LA has a bacterial etiology and the access way is through bacteremia. The most frequent germ is Staphylococcus aureus.

The case presented involves a two-year old girl, previously healthy, with a history of an unnoticed skin infection. She consulted for a several day-long fever, with nonspecific accompanying signs or symptoms. We performed imagenology tests during diagnosis that revealed the presence of a tumor in the left hypochondrium. We were able to perform an exploratory laparoscopy, diagnose and drain a single abscess in the left liver lobe. The extracted pus culture showed methicillin-sensitive S. aureus. She received antibiotic treatment for a month, with excellent further evolution. A month after the procedure, the residual cavity had disappeared when checked via ultrasound. This pathology is interesting due to its low frequency in children and to its diagnostic difficulties.

Keywords : Pyogenic liver abscess; Staphylococcus aureus; Child.

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