An Uncommon Cause of Chest Pain: Multiloculated Hepatic Abscess in a Patient with Strongyloides Stercoralis Infection

Serrano Gomez Yaritza^1, , Aneke Ijeoma¹ and Zonouzi-Zadeh Farideh¹

¹Department of Family Medicine, Northwell Glen Cove Hospital, Glen Cove, USA

Cite this paper

Serrano Gomez Yaritza, Aneke Ijeoma and Zonouzi-Zadeh Farideh. An Uncommon Cause of Chest Pain: Multiloculated Hepatic Abscess in a Patient with Strongyloides Stercoralis Infection. American Journal of Medical Case Reports. 2022; 10(4):113-116. doi: 10.12691/AJMCR-10-4-7

Abstract

Liver abscesses are purulent collections in the liver parenchyma that result from bacterial, fungal, or parasitic infections. Infection can spread to the liver through the biliary tree, hepatic vein, or portal vein when an adjacent infection or trauma expands. We report a case of a 53-year-old male who presented to an ambulatory clinic for evaluation of substernal chest pain. He reported associated palpitations, chills, shortness of breath, and diaphoresis. An abdominal CT revealed a mass with multiple loculations in the right and caudate hepatic lobe consistent with an abscess. Blood cultures grew Klebsiella pneumoniae, and ova and parasite exams showed Strongyloides stercoralis larvae. After four weeks of antibiotic treatment, a follow-up abdominal CT demonstrated complete resolution of the hepatic abscess. This case is an unusual presentation of a hepatic abscess as the patient did not report abdominal symptoms.

Keywords

multilobulated liver abscess, strongyloidiasis, bacteremia, chest pain

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Sotto Mayor, J., Robalo, M. M., Pacheco, A. P., & Esperança, S. (2016). Pyogenic liver abscess: uncommon presentation. BMJ case reports, 2016, bcr2016214841.
[2]	Bachler P, Baladron M, Menias C, Beddings I, Loch R, Zalaquet E, Vargas M, Connolly S, Bhalla S, Huete A. Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls. RadioGraphics 2016; 36: 1001-1023.
[3]	Hosoda, T., Sakamoto, M., Orikasa, H., Kubomura, A., Misaki, T., & Okabe, N. (2020). Septic Meningitis and Liver Abscess due to Hypermucoviscous Klebsiella pneumoniae Complicated with Chronic Strongyloidiasis in a Human T-lymphotropic Virus 1 Carrier. Internal medicine (Tokyo, Japan), 59(1), 129-133.
[4]	Shull H, Bejjani A, Kahn D. Hepatic Abscess in a Returning Traveler with Crohn’s Disease: Differentiating Amebic from Pyogenic Liver Abscess. Hindawi Case Reports in Medicine. Vol2018.
[5]	Braun, David S. MD1; John, Elizabeth MD1; Mehta, Ashwini DO1 S2606. The First Documented Case of Strongyloides Liver Abscess with Superimposed Methicillin-Resistant Staph aureus Infection, The American Journal of Gastroenterology: October 2020 - Volume 115 - Issue - p S1369.
[6]	Longworth, S., & Han, J. (2015). Pyogenic liver abscess. Clinical liver disease, 6(2), 51-54.
[7]	Mora Carpio AL, Meseeha M. Strongyloides Stercoralis. [Updated 2021 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436024/.
[8]	Braun, David S. MD1; John, Elizabeth MD1; Mehta, Ashwini DO1 S2606. The First Documented Case of Strongyloides Liver Abscess with Superimposed Methicillin-Resistant Staph aureus Infection, The American Journal of Gastroenterology: October 2020 - Volume 115 - Issue - p S1369.
[9]	DeFilippis, A. P., Andrew P. DeFilippis Andrew P. DeFilippis, Chapman, A. R., Andrew R. (A.R.C., Lemos, J. A. de, James A. de Lemos Division of Cardiology, Arbab-Zadeh, A., Armin Arbab-Zadeh, Newby, L. K., L. Kristin Newby, Morrow, D. A., David A.The online-only Data Supplement is available with this article: http://n8t.cn/Y2tZI. P. DeFilippis, & Al., E. (2019, August 16). Assessment and treatment of patients with type 2 myocardial infarction and acute nonischemic myocardial injury. Circulation. Retrieved April 21, 2022.