Acute necrotizing pancreatitis with pancreatic abscess due to Prevotella species in a diabetic.
Acute pancreatitis occasionally presents as pancreatic abscess with complications like pleural effusion and ascites. There are several pre-disposing factors, the most common being cholelithiaisis, alcohol abuse, infective causes, trauma, and metabolic causes such as diabetic ketoacidosis, while some cases are idiopathic. Here, we report a rare case of acute necrotizing pancreatitis in a 40-year-old male who presented with pain in the abdomen, ascites and left basal pleural effusion. A computerized tomography (CT) scan showed findings suggestive of pancreatic necrosis, with abscess formation and free-fluid surrounding area. The aspirated pus sample was processed for Gram staining and culture, which yielded growth of Prevotella species in an anaerobic culture. Exploratory laparotomy was performed and intra-abdominal collection drained. Necrosectomy of the distal tail and body of the pancreas was performed. The patient was started on antibiotics and along with supportive treatment, responded well.
Sonavane
A
A
Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai - 400 022, India.
Baradkar
V
V
Salunkhe
P
P
D'Souza
D
D
Kumar
S
S
D000038:Abscess / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016866:Bacteroidaceae Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D004322:Drainage; D006801:Humans; D007813:Laparotomy; D008297:Male; D010179:Pancreas / Q000382:microbiology / Q000473:pathology*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D018720:Prevotella / Q000302:isolation & purification*; D011860:Radiography, Abdominal; D014054:Tomography; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents