Abstract:
A 57-year-old female patient presented with fever, nausea, vomiting, loss of appetite, and weight loss within the last two months. Ceftriaxone and metronidazole therapy was started upon discovery of a liver abscess but provided no benefit. Following the of abscess biopsy, the patient developed fever, itching, anemia, acute renal failure, hyperbilirubinemia, and eosinophilia that required intensive care unit (ICU) admission. The Fasciola hepatica antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Triclabendazole was started, after which the symptoms and magnetic resonance imaging (MRI) findings regressed. Even without eosinophilia, F. hepatica should be considered in cases with a liver abscess that does not respond to antibiotics.
摘要:
一名57岁的女性患者出现发烧,恶心,呕吐,食欲不振,在过去的两个月内减肥。头孢曲松和甲硝唑治疗是在发现肝脓肿后开始的,但没有任何益处。脓肿活检后,病人出现发热,瘙痒,贫血,急性肾功能衰竭,高胆红素血症,和嗜酸性粒细胞增多,需要入住重症监护病房(ICU)。采用酶联免疫吸附试验(ELISA)检测肝片吸虫抗体。开始使用三氯多唑,之后,症状和磁共振成像(MRI)结果消退。即使没有嗜酸性粒细胞增多,对于对抗生素无反应的肝脓肿,应考虑肝肝纤维化。