Staphylococcal liver abscess and acute cholecystitis in a patient with Crohn's disease receiving infliximab.
We present an unusual case of empyema of the gallbladder associated with a pyogenic liver abscess in a patient with Crohn's disease on Infliximab. It manifested by weakness, weight loss, and vague abdominal pain, which eventually localized to the right upper quadrant 4 days prior to admission. Diagnostic evaluation, which included ultrasonography and computed tomography, revealed cholelithiasis, gallbladder wall thickening, and a low-attenuation, complex mass in the left hepatic lobe. Cholecystectomy and open drainage of the liver abscess were successfully performed. There are few reports of intrahepatic abscess associated with Crohn's disease. The relationship between acute cholecystitis and Crohn's disease has also been documented. However, this report documents the unusual complication of pyogenic liver abscess secondary to acute cholecystitis in the unique population of Crohn's disease patients on Infliximab.
Patel
Tushar R
TR
Department of Surgery, Division of General Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, 09803, USA.
Patel
Kepal N
KN
Boyarsky
Andrew H
AH
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D002763:Cholecystectomy; D002764:Cholecystitis / Q000150:complications*; D002769:Cholelithiasis / Q000150:complications; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D004322:Drainage; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D000069285:Infliximab; D046290:Liver Abscess, Pyogenic / Q000209:etiology*; D008297:Male; D013203:Staphylococcal Infections / Q000209:etiology*; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects*
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab