rifampin and Liver-Abscess

Tuberculous liver abscess is a rare disease entity even in endemic areas of Mycobacterium tuberculosis. It is usually accompanied by pulmonary tuberculosis or enteric tuberculosis. Further, an isolated tuberculous liver abscess is extremely rare. The disease is diagnosed by laparotomy or postmortem autopsy in most cases, and some authors adopted a 9-month antituberculosis regimen. We herein report a case of an isolated tuberculous liver abscess that initially manifested as persistent fever and general malaise, which was diagnosed by liver biopsy and treated successfully with a 6-month antituberculosis regimen and percutaneous abscess drainage.

Topics: Aged; Antitubercular Agents; Biopsy; Blood Chemical Analysis; Drug Combinations; Ethambutol; Humans; Isoniazid; Laparotomy; Liver; Liver Abscess; Male; Mycobacterium tuberculosis; Pyrazinamide; Rifampin; Tuberculosis

Tuberculous liver abscess has been reported in only fourteen patients in Japan and in twenty-nine patients outside Japan. Only nine of the non-Japanese patients and none of the Japanese patients have been treated for this condition without laparotomy. We report a patient who developed tuberculous liver abscess during treatment of tuberculous peritonitis. Diagnosis was made by ultrasound-guided aspiration biopsy, and the patient was treated with percutaneous drainage and transcatheter infusion of antituberculous agents. Direct infusion of antituberculous agents has more direct effects in the treatment of an abscess than systemic chemotherapy alone. Therefore, if a percutaneous catheter can be safely placed, the use of transcatheter infusion of antituberculous agents should be considered.

Topics: Administration, Cutaneous; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Liver Abscess; Middle Aged; Peritonitis, Tuberculous; Rifampin; Tuberculosis, Hepatic

Because of its infrequent and the lack of clinical data and image finding, the management of acute infections with the hepatosplenic brucella abscesses is challenging.. There were 10 serologically diagnosed cases with this brucella infection. All patients had fever, 50% patients had upper abdominal pain. Ninety percent patients lived in an urban environment. The localization of lesions included: 30% hepatosplenic, 30% liver, and 40% spleen.. Abdominal computed tomography (CT) scans and magnetic resonance imaging (MRI) demonstrated hepatosplenomegaly, with multiple small abscess lesions of various sizes in the acute stage of brucellosis, with the largest diameter of 1.5 cm in the liver. After contrast-enhanced CT and MRI findings, the arterial phase in which the enhancing area of lesions was thick, revealed multifocal hypodense or hypointense lesions of various sizes. These lesions manifested distinct boundary, which was intensified obviously in portal venous phase.. Our results indicate that early CT or MRI dynamic contrast enhancement of suspected cases could improve rapid diagnosis. However, diagnostic criteria remain problematic and diagnosis is mostly based on a combination of clinical suspicion, serologic markers, and radiologic findings.

Topics: Adolescent; Aged; Brucellosis; China; Doxycycline; Female; Humans; Liver Abscess; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Retrospective Studies; Rifampin; Splenomegaly; Tomography, X-Ray Computed; Treatment Outcome

Positive cultures from hepatic abscess drainage are extremely rare, and in this case the infection would have remained undiagnosed if Brucella suis had not been isolated. Failure to correctly diagnose this zoonosis delays patient treatment and is dangerous, as in this case that could have been a laboratory-acquired disease. This type of infection is preventable if proper safety protocols are established and followed.

Topics: Aged; Brucella suis; Brucellosis; Doxycycline; Drainage; Humans; Liver Abscess; Male; Rifampin; Tomography, X-Ray Computed; Treatment Outcome

Topics: Antibiotics, Antitubercular; Antitubercular Agents; Ethambutol; Humans; Isoniazid; Liver Abscess; Male; Middle Aged; Pyrazinamide; Rifampin; Tuberculosis, Hepatic

Hepatic abscess caused by brucellosis is extremely rare in children. We report the case of a 5-year-old girl in whom an abscess of the liver developed during an episode of acute brucellosis. To our knowledge, this is the second reported case of hepatic abscess caused by brucellosis in a child.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Brucella melitensis; Brucellosis; Child, Preschool; Female; Gentamicins; Humans; Liver Abscess; Magnetic Resonance Imaging; Rifampin; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography

Topics: Abdominal Pain; Adult; Animals; Brucella; Brucellosis; Calcinosis; Combined Modality Therapy; Doxycycline; Drug Therapy, Combination; Fever; Food Contamination; Food Microbiology; Hepatectomy; Humans; Liver Abscess; Male; Milk; Recurrence; Rifampin

Topics: Brucellosis; Ciprofloxacin; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Liver Abscess; Middle Aged; Rifampin; Severity of Illness Index; Tetracycline; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler

Topics: Antibiotics, Antitubercular; Cat-Scratch Disease; Child; Child, Preschool; Diagnosis, Differential; Fever of Unknown Origin; Humans; Liver Abscess; Male; Rifampin; Spleen; Splenic Diseases; Ultrasonography

The authors report two cases of tuberculous liver abscess. They stress the rarity of this site, and differential diagnostic difficulties with other types of infection and liver tumors, notably amebiasis, hydatid cyst and carcinoma. Echo- or Scan-guided needle biopsy is useful for diagnosis and, in some cases, treatment by drainage of the purulent cavity.

Topics: Adult; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Isoniazid; Liver Abscess; Pyrazinamide; Rifampin; Tuberculosis, Hepatic

Most of the successful non-surgical management of abdominal abscesses is based upon the presence of therapeutic amounts of effective antibiotics within the collection. However few data are currently available concerning antimicrobial levels in human purulent lesions. To study the relationship between serum and pus concentrations of rifampicin, 11 patients with deep-seated abscesses were given 900 mg intravenously of rifampicin daily; after 3, 8 and 20 h from injection, an ultrasound-guided percutaneous aspiration of the collection was performed. Samples were obtained on the first day of therapy in six cases, while in other six the aspiration took place on the third day. Rifampicin levels of therapeutic value were present after 8 h from the first injection. From this time antibiotic amounts in pus, ranging from 1.6 to 5.8 mg/l, were consistent with a long persistence of rifampicin in abscesses, without any evidence of accumulation.

Topics: Abscess; Humans; Infusions, Parenteral; Kinetics; Liver Abscess; Rifampin; Saliva; Suppuration