A rare hepatic abscess by Streptococcus intermedius complicated with hepatobronchial fistula: a case report
Authors: Jose Martin De Santiago Valenzuela, Luis Francisco Pineda Galindo, Zeltzin Olivia Guerrero Mancinas, Ana Belem Clotilde Castro Ponce, Carlos Fitzner Degante
Background: Hepatobronchial fistula is infrequent and secondary to pyogenic abscess caused by Streptococcus intermedius. This agent causes infections such as hepatic abscesses, endocarditis, bacteremia, and others. The treatment includes drainage, antibiotic management, and surgical intervention in some cases. Case Presentation: We describe a case of a 50-year-old male with a pyogenic liver abscess complicated by hepatobronchial fistula, admitted to the Internal Medicine Department with fever, long-lasting chills, and weight loss. The diagnostic approach revealed a pyogenic abscess secondary to S. intermedius. After percutaneous drainage, the patient presented purulent expectoration. A cavitogram revealed a hepatobronchial fistula. Treatment with antibiotics and closure of the defect was satisfactory. Conclusion: This is a case of a hepatic abscess due to S. intermedius complicated with hepatobronchial fistula, a rare clinical entity; the opportune hybrid approach (surgical plus interventional and radiological) reduces the risk of a major thoracoabdominal operation, which influenced the good prognosis of our patient.
Keywords: Hepatobronchial fistula, hepatic abscess, Streptococcus intermedius, fever, cavitogram, case report.
Authors
Jose Martin De Santiago Valenzuela
Internal Medicine Department, Piso 7. UMAE-Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social. Seris y Zaachila S/N, Col. La Raza, Azcapotzalco, C.P. 02990. Mexico
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Luis Francisco Pineda Galindo
Internal Medicine Department, Piso 7. UMAE-Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social. Seris y Zaachila S/N, Col. La Raza, Azcapotzalco, C.P. 02990. Mexico
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Zeltzin Olivia Guerrero Mancinas
Internal Medicine Department, Piso 7. UMAE-Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social. Seris y Zaachila S/N, Col. La Raza, Azcapotzalco, C.P. 02990. Mexico
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Ana Belem Clotilde Castro Ponce
Internal Medicine Department, Piso 7. UMAE-Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social. Seris y Zaachila S/N, Col. La Raza, Azcapotzalco, C.P. 02990. Mexico
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Carlos Fitzner Degante
Internal Medicine Department, Piso 7. UMAE-Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social. Seris y Zaachila S/N, Col. La Raza, Azcapotzalco, C.P. 02990. Mexico.
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Correspondence to:
Jose Martin De Santiago Valenzuela, Internal Medicine Department, Piso 7 UMAE-Especialidades “ jmartin0102@hotmail.com
Publication history:
Received 25 Mar 2020
Revised 06 Mar 2021
Accepted 13 Mar 2021
Published online 28 Mar 2021
Published in print 31 Mar 2021