• Clinical and Experimental Pediatrics
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• 제56권9호
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• pp.407-410
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• 2013

Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.

• Neonatal Medicine
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• 제15권1호
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• pp.105-110
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• 2008

신생아 간농양은 특별한 증상이 발현되지 않거나 비특이적인 증상 때문에 진단이 늦어지는 경우가 많다. 항생제의 사용에도 불구하고 염증 반응이 지속되며 복부증상이 함께 나타나는 경우, 주산기 산모의 심한 감염, 융모양막염 등의 선행인자가 있고, 제대혈관 도관과 관련된 패혈증이 있는 경우에는 간농양의 가능성을 고려해야 한다. 저자들은 생후 9일된 미숙아에서 제대정맥 도관과 함께 산모의 폐렴 및 심한 융모양막염이 선행요인이 되어, 단일성 간농양이 발생한 진단된 사례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.267-270
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• 2005

Referred pain is not localized to the site of its cause, but referred to an area that may be an adjacent distant from such a site. With respect to this, there is the possibility of misdiagnosis in the treatment of referred pain patient. We experienced a case of a 31-years-old male patient complaining of right shoulder pain, which subsided after a bursa injection. The patient revisited our clinic after 3 weeks complaining not only of right shoulder pain, but also of right upper quadrant pain and fever. He was diagnosed as having a liver abscess by an imaging study.

• Journal of Yeungnam Medical Science
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• 제37권3호
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• pp.246-249
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• 2020

Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

• Journal of Chest Surgery
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• 제29권7호
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• pp.785-788
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• 1996

간농양에 이은 급성 화농성 심낭염은 드문 질환이다. 급성화농성 심낭염은 적절한 치료가 이루어지지 않을 경우 사망율이 매우 높은 위 험한 질환이다. 환자는 32세 남자 환자로 발열, 오한, 상복부동통 및 호흡곤란을 주소로 응급실로 내원 하였다. 단순 흉부사진상 심비대의 소견을 보이고 있었으며, 복부초음파상 간좌엽에 종괴가 있었다. 심초음파상 임박 심장압진의 소견을 보이고 있었다. 응급으로 횡격막천공을 통해 간농양을 배농시켰고 심낭절개술을 시 행하였다. 심낭은 비후되어 두꺼워져 있었고 600m1의 악취가 나는 농액과 괴사조직들이 배액되었다. 섬유소응괴(abrinclot)가심근과유착이 있었다 조직학적 검사상심낭은급성 염증소견과 미세한 괴사 소견을 보이고 있었고, 균배양검사상 혈액과 배농액 에서 모두 Escherichia coli가 나왔다. 환자는 항생제 치료 받고 4주만에 퇴원 했고 심초음파상 약간의 교착성 심낭염의 소견을 보였다.

• 대한핵의학회지
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• 제20권1호
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• pp.25-31
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• 1986

This study was performed to establish normal hepatoscintiangiographic(HSA) pattern of hepatic blood flow and to investigate dynamic differential HSA findings of primary and metastatic carcinomas and abscess of the liver. HSA was carried out after intravenous bolus injection of 10 mCi of Tc-99m-phytate by obtaining sequential anterior images of 1-second exposure for 16 seconds. Observations included (1) baseline study of normal hepatic blood flow pattern by correlating with contrast angiogram, (2) time sequence phasing of normal HSA, and (3) analysis of altered patterns in primary and metastatic carcinomas and abscesses of the liver. Materials consisted of 20 normal subjects, 28 primary hepatocellular carcinomas, 16 metastatic carcinomas and 7 liver abscesses. Results were: (1) Normal HSA demonstrated 3 distinct phases of arterialization(AP), of arterial hepatogram(AHP), and of portal venous hepatogram(PVHP). The means of each phase were 5.3, 6.3 and 8.3 seconds, respectively. Portal vein could be seen in all but one of 20 normal subjects. (2) Pattern changes in diseases groups were early start of AP in carcinomas and very early start of AP in abscesses. AP became prolonged in all disease group. (3) Distinction between AHP was sharp in metastasis and abscesses but un sharp in primary hepatoma. Cold area or areas became vascularized in primary hepatoma but not in abscess. Cold areas of metastasis were inhomogeneously vascularized in late AP and throughout AHP and became relatively vascular as PVHP began. The cold area of abscess showed rim enhancement during AH and APH. These differences in HSA pattern were very useful in differential diagnosis of the diseases studied.

• 한국임상수의학회지
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• 제3권1호
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• pp.255-263
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• 1986

The incidences of liver abscess, fatty liver and fascioliasis were 11.9%, 23.2％ and 36.0%, respectively in 211 Holstein cattle observed at the slaughter house. Blood chemical values of them were measured. The results were as follows : 1. Liver abscess group was significantly higher than normal group in the levels of SDH, AST, TP, globulin and fibrinogen, but it was significantly lower than normal group in the levels of albumin and A/G ratio (p<0.01). 2. Fatty liver group was significantly higher than normal group in the levels of SDH, AST, OCT, TP and globulin, but it was significantly lower than normal group in the levels of albumin and A/G ratio (p<0.01). 3. Fasciolisais group was significantly higher than normal group in the levels of AST. TP and globulin (p<0.01), but it was significantly lower than normal group in the levels of albumin and A/G ratio (p<0.01).

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.96-100
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• 2017

Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infection. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.

• Journal of Chest Surgery
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• 제24권6호
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• pp.585-589
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• 1991

We experienced a rare hepatic tuberculous granuloma with subphrenic abscess. The patient was 45-years old female. She complained the right flank pain and tenderness on the protruding mass for 2 weeks. It was fixed, erythematous and 5x5cm sized mass, which was thought as cold abscess. She has done the hysterectomy as endometriosis at November 1990. Under general endotracheal anesthesia, the mass was incised, but the pus was not found. The needle aspiration was done through the 8th ICS, then the yellowish non-foul odor pus was rushed out. The 7th and 8th ribs were resected segmentally about 5cm. The abscess cavity was placed in the subphrenic area, therefore the operative fields extended along the 8th ICS. After the evacuation of subphrenic abscess, the granulomatous tissues from the superior aspect of liver was seen. The granuloma was resected and the penrose drainage was inserted. The tuberculosis was resulted from the 8th ICS muscles. subphrenic abscess and granuloma on the pathology report.

• Journal of Korean Neurosurgical Society
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• 제44권6호
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• pp.382-384
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• 2008

Gas forming brain abscess is a rare disease caused by Klebsiella pneumoniae occurring in patients with impaired host defense mechanism such as diabetes mellitus or liver cirrhosis. A 59-year-old man with 2-year history of diabetes mellitus and 20-year history of liver cirrhosis presented to the hospital with headache. On the day after admission, severe headache was developed and he deteriorated rapidly. Brain CT showed a non-enhanced mass including multiple air density as well as surrounding edema seen in the right occipital lobe, and isodensity air-fluid level seen in the right lateral ventricle. Despite emergent ventricular drainage and intraventricular and intravenous administration of antibiotics, his condition progressively worsened to sepsis and to death after 5 days. Bacterial culture of blood and ventricular fluids disclosed a Gram (-) rod, Klebsiella pneumoniae. In this report we review the pathogenic mechanism and its management.