Emphysematous hepatitis with successful treatments: A rare case report

• Published in: Medicine (Baltimore) Vol. 102; no. 4; p. e32530
• Main Authors: Pan, Nannan, Wang, Shuo, Miao, Zhenwei
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 27.01.2023
• Subjects: Anti-Bacterial Agents - therapeutic use; Clinical Case Report; Diabetes Mellitus - drug therapy; Emphysema - diagnostic imaging; Emphysema - therapy; Hepatitis - drug therapy; Hepatitis A; Humans; Liver Diseases - drug therapy; Male; Middle Aged
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000032530

Emphysematous hepatitis (EH) is a rare and fulminant gas-forming liver infection. Only 3 patients were successfully treated. Diabetes mellitus and a history of digestive system cancer may predispose individuals to EH. Computed tomography (CT) findings support the diagnosis of EH and monitor progress. A 48-year-old man with diabetes presented with nausea, vomiting (gastric contents) and diarrhea. Laboratory test results revealed elevated levels of inflammatory indicators and abnormal liver function. CT showed a large-scale air collection with some remaining parenchymal debris in the left lobe of the liver. Remarkably, no fluid was observed inside the lesion. The abdominal CT features and laboratory examination results rationalized the diagnosis of EH. The patient finally recovered from this severe disease through a series of effective treatments, including strict glucose control, sensitive antibiotic therapy, and subsequent percutaneous drainage. EH generally deteriorates rapidly and eventually leads to death. This case will raise awareness of the rare and severe disease, strengthen diagnostic capacities, and provide advice to treat it.