Greater omentum flaps and granulocyte transfusions as combined therapy of liver abscess in chronic granulomatous disease.
We report the case of a 17-year-old boy with gp91phax-deficient chronic granulomatous disease who developed a liver abscess due to Staphylococcus aureus. Despite treatment with appropriate antibiotics and gamma interferon for three months as well as incision and drainage, the abscess persisted unchanged in size. After surgical debridement, the abscess cavity was filled with two pedunculated greater omentum flaps as a direct feeder road of granulocytes to the infectious focus. An average of 48.5 x 10(9) granulocytes a day harvested from G-CSF-prestimulated donors were transfused for a total of 8 days without side effects. Ultrasound 3 months later showed no residual abscess. Combination of greater omentum flaps and transfusion of G-CSF-prestimulated granulocytes may be the optimal treatment for liver abscesses refractory to conventional therapy.
von Planta
M
M
University Children's Hospital Zurich, Switzerland.
Ozsahin
H
H
Schroten
H
H
Stauffer
U G
UG
Seger
R A
RA
D000293:Adolescent; D003131:Combined Modality Therapy; D006105:Granulomatous Disease, Chronic / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D017708:Leukocyte Transfusion; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery*; D008297:Male; D008562:Membrane Glycoproteins / Q000172:deficiency / Q000235:genetics; D000074662:NADPH Oxidase 2; D019255:NADPH Oxidases; D009504:Neutrophils / Q000637:transplantation*; D012729:Sex Chromosome Aberrations / Q000235:genetics; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014960:X Chromosome
D008562:Membrane Glycoproteins; C056558:CYBB protein, human; D000074662:NADPH Oxidase 2; D019255:NADPH Oxidases