Clostridium perfringens Liver Abscess Disguised as Biliary Disease: A Report of Two Cases and a Review of the Literature

作者全名："Peng, Jialun; Zhai, Qilong; Li, Jinzheng; Chen, Xingyu; Wu, Hongyu; Zhong, Tao; Tang, Gangyi; Yu, Dajun; He, Lixian; Li, Jinxu"

作者地址："[Peng, Jialun; Zhai, Qilong; Li, Jinzheng; Chen, Xingyu; Wu, Hongyu; Zhong, Tao] Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Tang, Gangyi; Yu, Dajun; He, Lixian; Li, Jinxu] Wushan Cty Peoples Hosp Chongqing, Dept Gen Surg, Chongqing 404700, Peoples R China"

通信作者："Li, JZ (通讯作者)，Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 2, Chongqing 400010, Peoples R China.; Tang, GY (通讯作者)，Wushan Cty Peoples Hosp Chongqing, Dept Gen Surg, Chongqing 404700, Peoples R China."

来源：INFECTION AND DRUG RESISTANCE

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001049499700001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：16

期号：　

开始页：5209

结束页：5222

文献类型：Review

关键词：intravascular hemolysis; biliary diseases; diagnosis; treatment

摘要："Liver abscesses caused by Clostridium perfringens are rare but rapidly fatal. In only a few days, patients progress from liver abscess to sepsis, intravascular hemolysis, multiple organ failure, and even death. These abscesses often occur in patients after trauma or surgery or in those with immunodeficiency. Because patients only show non-specific symptoms such as fever and abdominal pain in the early stage, they can easily be misdiagnosed and miss the therapeutic window, resulting in a poor prognosis. The diagnosis of Clostridium perfringens liver abscess mainly depends on computed tomography (CT), needle aspiration, and/or blood culture. After diagnosis, treatments such as antibiotic therapy, surgical abscess drainage, blood transfusion as needed, and correction of metabolic disturbances must be immediately administered to prevent severe complications. Here, we present two cases of liver abscess due to Clostridium perfringens infection. Both patients initially presented only with fever, abdominal pain, and jaundice, symptoms that were easily confused with cholangitis caused by cholelithiasis. The patients then progressed rapidly and, despite receiving antimicrobial and multimodal sepsis treatment, both eventually died of multiple organ dysfunction syndrome. Clinicians should be on high alert for Clostridium perfringens liver abscesses disguised as biliary disease. Early diagnosis and treatment with the appropriate antibiotics and surgery are fundamental for the survival of the affected patients."

基金机构：Joint project of Chongqing Health Commission and Science and Technology Bureau [:2022GDRC004]; Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University

基金资助正文："Funding The work was supported by the Joint project of Chongqing Health Commission and Science and Technology Bureau (NO:2022GDRC004) , Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University."