title: Infected solitary hepatic cyst.
abstract: An unusual case involving an infected hepatic cyst in which the correct diagnosis was made without operation is reported. A 93-year-old woman presented with acute onset of right upper quadrant abdominal pain, mild left lower quadrant abdominal pain, diarrhea, and fever. On admission, computed tomography revealed a 15 cm solitary hepatic cyst in the anterior-superior segment of the liver with a thickened wall that enhanced with contrast media. Ultrasonography demonstrated a 15 cm anechoic lesion with a hypoechoic area in the dependent portion of the cyst and a thickened wall. The serum concentration of C-reactive protein was 24.3 mg/dL, and the white blood cell count was 13,800/microL. A diagnosis of infected hepatic cyst was suspected, and percutaneous transhepatic drainage of the cyst was performed. Milky yellow fluid was obtained and the patient's right upper quadrant abdominal pain resolved after drainage. Klebsiella pneumoniae was cultured from the drainage fluid. The patient was discharged 20 days after drainage. Infection has not recurred and the hepatic cyst has not enlarged after 18 months.
authors.affiliation: First Department of Surgery, Nippon Medical School, Tokyo, Japan. hiroshiy@nms.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Takahashi
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Eiichi
authors.initials: E
authors.lastname: Uchida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000150:complications*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications*; D007711:Klebsiella pneumoniae; D008107:Liver Diseases / Q000150:complications*