RESUMO
Liver abscesses are an entity that sets out a diagnostic challenge with a severe clinical course and non-negligible mortality. Their origin is usually bacterial (>80%), parasitic, mixed or, more rarely, fungal. We present the case report of a 45-year-old man, native of Ghana, with no relevant medical-surgical history, was admitted for septic shock with multiple organ dysfuntion syndrome. Complementary imaging tests revealed a liver abscess in segments IV and VII measuring 60x45x54 mm, so antibiotic treatment with piperacillin-tazobactam was started and a pigtail drainage was placed. In blood cultures, the microorganism parvimonas micra (anaerobic gram-positive cocci) was isolated with high degree of sensitivity rates to penicillin, clindamycin and metronidazole. Treatment was de-escalated to clindamycin until completing 4 weeks of intravenous treatment. Control CT showed a decrease in the size of the abscess and pigtail drainage was removed.
Assuntos
Clindamicina , Abscesso Hepático , Masculino , Humanos , Pessoa de Meia-Idade , Clindamicina/uso terapêutico , Antibacterianos/uso terapêutico , Firmicutes , Abscesso Hepático/diagnóstico por imagem , Abscesso Hepático/tratamento farmacológicoRESUMO
Portal hypertension, responsible for the formation of oesophageal varices, also generates intra-abdominal varicose dilations, especially of the perisplenic and mesenteric veins, which, like the oesophageal veins, are susceptible to rupturing and bleeding, in this case within the peritoneal cavity. However, the spontaneous rupture of these intraperitoneal varices is a rare complication, and poorly described in the literature. We present the case of a 72-year-old woman with CHILD B liver cirrhosis of unknown aetiology with portal hypertension on primary prophylaxis with carvedilol.
