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Open Access Highly Accessed Case report

Resection of a methicillin-resistant Staphylococcus aureus liver abscess in a patient with Crohn’s disease under infliximab treatment: a case report

Junichi Togashi12, Yasuhiko Sugawara1*, Nobuhisa Akamatsu3, Taku Aoki1, Masayoshi Ijichi2, Mami Tanabe2, Koji Kusaka2, Masayuki Shibazaki2, Tokuma Tadami4, Minako Sakou4, Masakazu Takazoe4, Yasutsugu Bandai2 and Norihiro Kokudo1

Author Affiliations

1 Department of Surgery, Artificial Organ and Transplantation Surgery Division, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

2 Department of Surgery, Central Hospital of Social Health Insurance, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073, Japan

3 Department of Hepato-Biliary-Pancreatic Surgery, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe, Saitama, 350-8550, Japan

4 Department of Internal Medicine, Central Hospital of Social Health Insurance, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073, Japan

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Journal of Medical Case Reports 2013, 7:36  doi:10.1186/1752-1947-7-36

Published: 1 February 2013

Abstract

Introduction

A liver abscess in Crohn’s disease is a rare but important entity that is associated with a poor prognosis and high mortality when treatment is delayed. We report a case of successful liver segmentectomy for a methicillin-resistant Staphylococcus aureus liver abscess in a patient with Crohn’s disease under infliximab treatment.

Case presentation

A 31-year-old Japanese man, who had been treated with infliximab infusions for Crohn’s disease, was referred to our hospital presenting with an abrupt onset of high fever and an elevated white blood cell count and serum C-reactive protein level. Computed tomography revealed a liver abscess occupying segment 8. The limited effect of percutaneous transhepatic abscess drainage and antibiotics led us to perform radical resection of the abscess. The patient recovered quickly after surgery and the postoperative course was uneventful.

Conclusion

The present case suggests that surgical removal of an abscess should be considered for patients under immunosuppression or refractory to conventional treatment.