American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2020, 8(2), 53-55
DOI: 10.12691/ajmcr-8-2-4
Open AccessCase Report

An Unusual Case of Pyogenic Liver Abscess Caused by Community-acquired Methicillin-Resistant Staphylococcus aureus

Jeffrey Song1, , Tariq Sharman1 and Khubaib Gondal2

1Department of Medicine, Heritage College of Osteopathic Medicine, Southern Ohio Medical Center, Ohio University, Portsmouth, Ohio, U.S.A.

2Department of Medicine, Southern Ohio Medical Center, Portsmouth, Ohio, U.S.A.

Pub. Date: January 03, 2020

Cite this paper:
Jeffrey Song, Tariq Sharman and Khubaib Gondal. An Unusual Case of Pyogenic Liver Abscess Caused by Community-acquired Methicillin-Resistant Staphylococcus aureus. American Journal of Medical Case Reports. 2020; 8(2):53-55. doi: 10.12691/ajmcr-8-2-4


Hepatic abscesses are the most common type of visceral abscesses. The annual incidence is estimated at 2.3 cases per 100,000 people and is more common in men than women. A considerable proportion of pyogenic liver abscesses are caused by hepatobiliary pathologies. However, it may also result from hematogenous seeding from the systemic circulation. Most pyogenic liver abscesses are polymicrobial in nature consisting of anaerobic and enteric gram-negative bacilli species. Less than 10% of cases are caused by Staphylococcus aureus. Of these, few are caused by Methicillin-resistant Staphylococcus aureus (MRSA) and even fewer from the community-acquired strain. The clinical manifestations of pyogenic liver abscesses usually include fever, abdominal pain and non-specific symptoms like nausea, vomiting, malaise, anorexia and weight loss. Treatment of pyogenic liver abscesses consists of source control with drainage and antibiotic therapy tailored to the isolated causative organism. We present a case of a 51-year-old Caucasian man who presented with severe right upper quadrant abdominal pain of 5 days in duration. Abdominal Computed Tomography (CT) showed a 7.7 by 6.0 centimeter multi-loculated mass in the right hepatic lobe with other scattered foci throughout the liver. The abscess was aspirated with a pigtail drain placed under CT guidance. The aspirated culture grew MRSA sensitive to Doxycycline and Trimethoprim/Sulfamethoxazole.

MRSA abscess liver hepatic community-acquired Pyogenic

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[1]  The Evolving Nature of Hepatic Abscess: A Review . Mavilia, Marianna G, Molina, Marco and Wu, George Y. 2016, Journal of Clinical and Translational Hepatology , pp. 4(2): 158-168.
[2]  Hepatic Abscess: diagnosis and management. Lardiere-Deguelte, S, et al. 2015, Journal of vesceral surgery, pp. 152(4): 231-243.
[3]  Anaerobic liver abscess and intraheptic metastases. A case report and review of the literature. Trump, Donald L, et al. 1978, Cancer, pp. 682-686.
[4]  Multi-organ failure secondary to a Clostridium perfringens gaseous liver abscess following a self-limited episode of acute gastroenteritis. Eltawansy, Sherif Ali, et al. 2015, The American journal of case reports , p. 16: 182 .
[5]  Bacterial, Parasitic, and Fungal Infections of the Liver, Including Liver Abscesses-ClinicalKey. Arthur, Y and Kim, RT. 2016, Sleisenger and Fordtran's Gastrointestinal and Liver Disease, pp. 1374-1392 .
[6]  Community-Acquired Methicillin-Resistant Pyogenic Liver Abscess: A Case Report . Cherian, Joel , et al. 2016, Journal of Investigative Medicine High Impact , p. Volume: 4 issue: 3.
[7]  A community-acquired methicillin-resistant Staphlococcus aureus liver abscess. Wong, VW, et al. 2010, Hong Kong Medical Journal , pp. 16: 227-229.
[8]  Clinical Importance of Identifying Coagulase-Negative Staphylococci Isolated from Blood Cultures: Evaluation of MicroScan Rapid and Dried Overnight Gram-Positive Panels versus a Conventional Reference Method. Weinstein, Melvin P, et al. 1998, Journal of Clinical Microbiology, pp. July 36(7) 2089-2092 .
[9]  Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: a systematic review and meta-analysis. Cai, YL, et al. 2015, HPB, pp. 17(3): 195-201.
[10]  Treatment recommendations for patients from the community: Concerns regarding the new guidelines for treatment of intra-abdominal infection. Piacenti, F. 2010, Clinical infectious diseases , pp. 51(6): 755-757.
[11]  Cryptogenic pyogenic liver abscess as the herald of colon cancer. Jeong, SW, et al. 2012, Journal of gastroenterology and hepatology, pp. 27(2): 248-255.