Isolated hepatic tuberculous abscess in a renal transplant recipient.
Tuberculous liver abscess is rare worldwide. We report a 26-year-old renal transplant recipient who presented with fever, fatigue, and weight loss. Ultrasound (US) of the abdomen showed a cystic mass of 7x6 cm in the subcapsular region of right liver lobe. US-guided percutaneous drainage was performed and 100 mL of yellow-colored pus was aspirated. The patient was empirically started on ampicillin sulbactam treatment. Despite this treatment, the symptoms persisted. Subsequent control abdominal US showed the persistence of a cystic mass of 7x6 cm with thin septation in the subcapsular region near the right liver lobe, which were subsequently diagnosed as a focal hepatic tuberculous abscess by positive culture in Löwenstein-Jensen medium. He was concomitantly started on systemic antituberculous therapy. A tuberculous liver abscess must be considered in the differential diagnosis. Percutaneous drainage along with systemic antituberculous chemotherapy must be considered as an alternative to surgery for the management. A greater awareness of this clinical entity is required for successful treatment.
Caliskan
Y
Y
Division of Nephrology, Department of Internal Medicine, School of Medicine, Istanbul University, Turkey. yasarkerem@yahoo.com
Demirturk
M
M
Cagatay
A A
AA
Guven
D
D
Ozkan
O
O
Ecder
T
T
Turkmen
A
A
Sever
M S
MS
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology*; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014463:Ultrasonography
D000995:Antitubercular Agents