Published online Mar 27, 2018. doi: 10.4254/wjh.v10.i3.388
Peer-review started: December 20, 2017
First decision: January 23, 2018
Revised: January 30, 2018
Accepted: March 1, 2018
Article in press: March 1, 2018
Published online: March 27, 2018
We report the first case of a healthy 23-year-old female who underwent an interventional radiology-guided embolization of a hepatic adenoma, which resulted in a gas forming hepatic liver abscess and septicemia by Clostridium paraputrificum. A retrospective review of Clostridial liver abscesses was performed using a PubMed literature search, and we found 57 clostridial hepatic abscess cases. The two most commonly reported clostridial species are C. perfringens and C. septicum (64.9% and 17.5% respectively). C. perfringens cases carried a mortality of 67.6% with median survival of 11 h, and 70.2% of the C. perfringens cases experienced hemolysis. All C. septicum cases were found to have underlying liver malignancy at the time of the presentation with a mortality of only 30%. The remaining cases were caused by various Clostridium species, and this cohort’s clinical course was significantly milder when compared to the above C. perfringens and C. septicum cohorts.
Core tip: To our best knowledge, this is the first case where a liver abscess grew C. paraputrificum. Although pyogenic liver abscesses caused by Clostridium species are extremely rare, early and accurate diagnosis of clostridial hepatic abscess and timely interventions are paramount, as it carries an extremely high morbidity and mortality. However, depending on the exact causative Clostridium species, the clinical course can vary unexpectedly.