[Hepatic brucelloma: 2 cases and a review of the literature].
We report two new cases of hepatic brucelloma in addition to the 22 previously reported cases in the literature. Our analysis of these cases reveals certain characteristics. Hepatic brucelloma is a rare localization that follows previously undetected acute brucellosis. Brucelloma is a result of caseification of a granulomatous reaction induced by persistent Brucella in macrophages. Clinical manifestations can mimic malignant liver tumors or pyogenic, amebic liver abscess. Diagnosis is based on the association of characteristic imaging features (central calcification and peripheral necrotic areas), positive serology and hepatic granulomas. Brucella is rarely isolated in the blood or liver. Awareness of this clinical variant can prevent unnecessary laparotomy. Treatment should begin with rifampicine (900 mg per day) and doxycyclin (200 mg per day) for 3 months. If medical treatment is unsuccessful, percutaneous or surgical drainage should be performed. A cure should be achieved in all cases.
Halimi
C
C
Service d'Hépatologie et de Gastroentérologie, Centre Hospitalier Général, Senlis.
Bringard
N
N
Boyer
N
N
Vilgrain
V
V
Panis
Y
Y
Degott
C
C
Brouland
J P
JP
Boudiaf
M
M
Valleur
P
P
Henry-Biabaud
E
E
Valla
D
D
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002006:Brucellosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000627:therapeutic use; D006099:Granuloma / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D008264:Macrophages / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D004318:Doxycycline; D012293:Rifampin
Brucellome hépatique: deux nouveaux cas et revue de la littérature.