Article in Japanese

A case of bacterial liver abscess diagnosed by multi-microbial real time PCR after administering antimicrobial therapy

Eishi IKEDA^1,2）,Nobuyuki YOTANI^1,2）,Michiko YOSHIDA^3）, Takanori FUNAKI^3）,Kei YAMAMOTO^4）,Isao MIYAIRI ^3）

Pediatric liver abscess is a rare disease with an incidence of 5‒25 per 100,000 hospitalizations. The blood culture positivity rate is less than 20%‒30%, and the location and size of the abscess make drainage difficult. This study reports a case of liver abscess diagnosed by multi-microbial real time polymerase chain reaction (PCR) after administering antimicrobial therapy. A 4-year-old girl without past medical history was referred to this hospital after a CT scan was performed to investigate an unknown cause of fever and suspected liver abscess. After 17 days of treatment with cefotaxime and metronidazole without improvement, she was switched to meropenem and vancomycin for 11 days, but the abscess became enlarged. Abscess drainage was carried out by laparotomy. Methicillin sensitive Staphylococcus aureus was detected by a multi-microbial real time PCR test using intraoperative pathology specimens. In cases where results cannot be obtained by conventional culture tests, such as under prior antimicrobial therapy, a multi-microbial real time PCR test using pathological specimens may be the key to identify a causative microorganism.

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1） Center for Postgraduate Education and Training, National Center for Child Health and Development
2） Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development
3） Division of Infectious Diseases, Department of Medical Subspecialities, National Center for Child Health and Development
4） Disease Control and Prevention Center, National Center for Global Health and Medicine

Key words	child, liver abscess, multi-microbial real time polymerase chain reaction, Staphylococcus aureus
Received	February 1, 2022
Accepted	April 6, 2022

34 (2)：117─123,2022