A Case of Chronic Liver Abscess due to Alcaligenes Xylosoxidans Infection

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 74; no. 7; pp. 1979 - 1983
• Main Authors: UESUGI, Naomasa, YAGI, Takeshi, JINBO, Mitsutaka, SAITO, Satoshi, TAKAHASHI, Tsuyoshi, GOHRA, Hidenori
• Format: Journal Article
• Language: Japanese; English
• Published: Japan Surgical Association 2013
• Subjects: Alcaligenes xylosoxidans; liver abscess
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.74.1979

We describe a case of a 17-year history of chronic liver abscess developed after cholecystectomy. The patient was a 63-year-old woman who underwent cholecystectomy for cholecystolithiasis at 45 years of age. Intraabdominal abscess occurred after the operation, for which we performed percutaneous drainage and surgical drainage frequently. Several kinds of treatments failed to cure and a liver abscess and skin fistula were formed. In September 2011, she developed hemoptysis caused by empyema and underwent bronchial arterial embolization. On the basis of her clinical histories, we considered that hepatectomy for the liver abscess was necessary to control the chronic inflammatory disease. In May 2012, hepatectomy was thus performed. The resected specimen showed an irregular shaped abscess with fibrous encapsulation. Histological findings showed epithelioid cell granuloma surrounding the abscess. Her postoperative course was uneventful. Recovery of the inflammatory reaction occurred immediately after the surgery. Alcaligenes xylosoxidans was isolated by a culture of purulent matter from the abscess. To our knowledge, eight cases of chronic pyogenic liver abscess caused by Alcaligenes xylosoxidans infection, including our case, have been reported. All patients had a past history of cholecystectomy, long-term chronic symptoms, and poor prognosis. We report a very rare case of liver abscess due to Alcaligenes xylosoxidans infection with a review of the literature.