Pediatr Infect Vaccine.  2023 Dec;30(3):165-172. 10.14776/piv.2023.30.e21.

A Case of Pyogenic Liver Abscess Due to Prevotella intermedia in an Immunocompetent Child

• Kim HS
• Eun BW

• KMID: 2551467
• DOI: http://doi.org/10.14776/piv.2023.30.e21

Abstract

Pyogenic liver abscess is a rare condition in healthy children in developed countries, but it can have severe consequences if diagnosis and treatment are delayed. Staphylococcus aureus is the most commonly identified cause of pyogenic liver abscess worldwide, while Klebsiella pneumoniae is the predominant causative agent in Korea. However, cases of pyogenic liver abscess caused by anaerobic bacteria have also been rarely reported. A 14-year-old boy presented to the emergency room with fever and pain in the upper right abdomen. He exhibited tenderness in the right upper quadrant, elevated white blood cell count, anemia, and elevated liver enzyme levels. Abdominal computed tomography with contrast revealed pyogenic liver abscess. The patient underwent percutaneous catheter drainage for two weeks and received a 4-week course of antibiotic therapy. Prevotella intermedia, an anaerobic bacterium commonly found in the oral flora, was isolated from the drained pus. However, no evidence was found suggesting that the infection originated from a dental source. This case highlights the importance of considering the possibility of pyogenic liver abscess even in otherwise healthy children.

Keyword

Liver abscess; Immunocompetence; Prevotella; Child