ABSTRACT
We present the first case of hepatic actinomycosis requiring both medical and surgical intervention due to liver dissemination from a primary colonic abscess. A 52-year-old white male had a computerised (CT) abdominal scan following an episode of collapse and was found to have peri-colonic and hepatic abscesses. Prior to this episode, he suffered with a two month history of fever, unexplained weight loss, and anaemia suggesting possible malignancy. He was treated with both radiological and surgical drainage of the abscesses, alongside the antibiotic cover and underwent an anterior colonic resection with primary anastomosis. There have been no previous reports of an actinomycotic liver abscess complicating colonic diverticular abscess. A multi- team approach is recommended when disseminated actinomycotic infection is encountered.
Subject(s)
Actinomycosis/etiology , Diverticulitis, Colonic/complications , Liver Abscess/microbiology , Actinomycosis/diagnosis , Actinomycosis/therapy , Anti-Bacterial Agents/therapeutic use , Drainage/methods , Humans , Laparoscopy , Liver/surgery , Liver Abscess/diagnosis , Liver Abscess/therapy , Male , Middle Aged , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
We present the case of a patient referred to the gastroenterology service for investigation of abnormal liver function tests. She had been taking nitrofurantoin for 16 months as prophylaxis against urinary tract infections. CT scan showed evidence of lung pneumonitis and low attenuation in the liver parenchyma. Nitrofurantoin-induced pneumonitis and hepatotoxicity was diagnosed. The patient responded both clinically and biochemically to withdrawal of nitrofurantoin. This combination of adverse reaction to nitrofurantoin is rare.