title: Liver abscesses after peritoneal venous shunt.
abstract: A 70-year-old man was referred to our hospital for high-grade fever with chills. He has visited our hospital for alcoholic liver cirrhosis and diabetes mellitus for over 20 years. Nine months earlier, he had received a peritoneal venous shunt (Denver shunt®) because of refractory ascites. Laboratory examinations revealed elevated C-reactive protein and liver dysfunction. Ultrasonography and abdominal enhanced computed tomography showed multiple small abscesses in the right lobe of the liver. Blood culture test did not detect the pathogenic bacteria of liver abscesses. The patient was treated with antibiotics for more than 2 months and cured from the infection, but 3 months later, he developed high-grade fever again. He had a recurrence of multiple small liver abscesses involving both lobes of the liver. He was treated with antibiotics, and the abscesses disappeared within a month. After the antibiotic treatment, he had selective intestinal decontamination with kanamycin. He has had no recurrence of liver abscess for over a year. To our knowledge, this is the first report of liver abscess in a cirrhotic patient with Denver shunt. Clinicians should bear liver abscess in mind when treating patients with high-grade fever and liver dysfunction following Denver shunt implantation.
authors.affiliation: Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Kawaratani
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Tsujimoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Kubo
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Aihara
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takaya
authors.forename: Masakazu
authors.initials: M
authors.lastname: Uejima
authors.forename: Kei
authors.initials: K
authors.lastname: Moriya
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Noguchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yoshiji
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukui
keywords: Denver shunt; Liver abscess; Liver cirrhosis; Peritoneal venous shunt; Selective intestinal decontamination