Multidrug resistant citrobacter: an unusual cause of liver abscess

BMJ Case Rep. 2013 Apr 22:2013:bcr2013008714. doi: 10.1136/bcr-2013-008714.

Abstract

Liver abscesses are infectious, space occupying lesions in the liver, the two most common abscesses being pyogenic and amoebic. A pyogenic liver abscess (PLA) is a rare condition with a reported incidence of 20 per 100 000 hospital admissions in the western population. The right lobe of the liver is the most common site in both types of liver abscess. Clinical presentation is elusive with complaints of fever, right upper quadrant pain in the abdomen and hepatomegaly with or without jaundice. The aetiology of PLA has changed in the past few decades and may be of biliary, portal, arterial or traumatic origin, but many cases are still cryptogenic. The most common organisms causing PLA are Gram-negative aerobes, especially Escherichia coli and Klebsiella pneumoniae. Studies have shown a high degree of antimicrobial susceptibility of isolated organism resulting in an overall lower mortality in PLA. Here, we present a case of PLA caused by multidrug-resistant Citrobacter freundii, which is an unusual organism to be isolated.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Citrobacter / isolation & purification*
  • Contrast Media
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology*
  • Humans
  • Liver Abscess / drug therapy
  • Liver Abscess / microbiology*
  • Male
  • Meropenem
  • Middle Aged
  • Radiography, Interventional
  • Radiography, Thoracic
  • Thienamycins / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Contrast Media
  • Thienamycins
  • Meropenem