[A case report--typhoid fever complicated with liver and gallbladder abscess, treated for long-time as fever of unknown origin].
A 25-year-old male admitted to Kawasaki municipal hospital with the diagnosis of typhoid fever. He had noticed high fever since one month ago, and had been treated with prednisolone with the diagnosis of fever of unknown origin in a hospital. Then he had admitted to St. Marianna University Hospital, and Salmonella Typhi had been detected from his blood and stool. On admission, multiple liver abscess were detected by abdominal ultrasonography. S. Typhi in bile was not eliminated with CP and AMPC, but he was successfully treated with cholecystectomy and the chemotherapy of LVFX. Abscess formation was found in the resected gall bladder wall. Typhoid nodule in the lymph node, liver or other organs is a well known pathological change in the typhoid fever. But abscess formation in the liver or other organs is rare. In this case, multiple abscess is characteristic and this cause is thought to be induced by the factors that the period from onset of typhoid fever to beginning of effective therapy was too long, and that steroid therapy was done without antibiotic therapy.
Kawashima
I
I
Department of Internal Medicine, Kawasaki Municipal Hospital.
Suzuki
T
T
Suzuki
A
A
Obana
M
M
Suzuki
H
H
Matsuoka
Y
Y
Irimajiri
S
S
Fukuda
J
J
D000038:Abscess / Q000209:etiology* / Q000628:therapy; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D002763:Cholecystectomy; D003951:Diagnostic Errors; D005335:Fever of Unknown Origin; D005705:Gallbladder Diseases / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008100:Liver Abscess / Q000209:etiology* / Q000628:therapy; D008297:Male; D015242:Ofloxacin / Q000627:therapeutic use; D011239:Prednisolone / Q000009:adverse effects; D013997:Time Factors; D014435:Typhoid Fever / Q000150:complications* / Q000628:therapy
D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D015242:Ofloxacin