A case of amoebic liver abcess in a compromised host

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  • Compromised hostに発症したアメーバ性肝膿瘍の1例
  • 症例 Compromised hostに発症したアメーバ性肝膿瘍の1例
  • ショウレイ Compromised host ニ ハッショウ シタ アメーバセイ カン ノウヨウ ノ 1レイ

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Abstract

A 57-year-old man who had been treated with chemotherapy after surgery for a left testicular tumor at the urological department in our hospital was seen at our department because of right lower abdominal pain and fever. The WBC count was 39,490/mm3 and the CRP level was 21.78mg/dl, showing increased inflammatory reaction. Abdominal CT scan revealed inflammatory findings at the right side colon. Following administration of antibiotics, his clinical course was observed but no remission was gained. Right hemicolectomy was thus performed on the fifth hospital day. Even after the operation no responses to antibiotics were noted. Abdominal CT scan performed on the forth postoperative day showed extensive multiple liver abscesses. He died on the tenth postoperative day. Histopathology of the resected specimen disclosed amoebae. Many patients with amoebic infection are asymptomatic and in about 10% of them, amoebae invade the intestine to cause enteric amebiasis. Although the mechanism of the onset has been obscure, the uses of steroids and anticancer drugs are pointed out as factors to provoke the disease on the side of the hosts. In the case of an immuno-compromised host who is on adjuvant chemotherapy and resultantly is prone to infection, like our case, a possibility that his or her amoebic infection can rapidly progress is suggested.

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