Niu CY, Yao BT, Tao HY, Peng XG, Zhang QH, Chen Y, Liu L. Leukopenia-a rare complication secondary to invasive liver abscess syndrome in a patient with diabetes mellitus: A case report. World J Gastrointest Surg 2024; 16(10): 3343-3349 [PMID: 39575291 DOI: 10.4240/wjgs.v16.i10.3343]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3343-3349 Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3343
Leukopenia-a rare complication secondary to invasive liver abscess syndrome in a patient with diabetes mellitus: A case report
Chun-Yan Niu, Bang-Tao Yao, Hua-Yi Tao, Xin-Gui Peng, Qing-Hua Zhang, Yue Chen, Lu Liu
Chun-Yan Niu, Hua-Yi Tao, Yue Chen, Lu Liu, Department of Gastroenterology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
Bang-Tao Yao, Department of Ophthalmology, Nanjing Lishui People’s Hospital, Nanjing 211200, Jiangsu Province, China
Xin-Gui Peng, Qing-Hua Zhang, Department of Medical Imaging, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 210009, Jiangsu Province, China
Co-first authors: Chun-Yan Niu and Bang-Tao Yao.
Co-corresponding authors: Yue Chen and Lu Liu.
Author contributions: Niu CY and Yao BT conceived the designing, acquiring and analyzing data and wrote the manuscript; Tao HY collected the data; Peng XG and Zhang QH analyzed the imaging and contributed to diagnosis; Chen Y and Liu L established the diagnosis and reviewed the manuscript; All authors read and approved the final manuscript; Niu CY and Yao BT contributed equally.
Supported bythe 2022 Nanjing Health Science and Technology Development Special Fund Support Project, No. YKK22240.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: June 7, 2024 Revised: September 6, 2024 Accepted: September 14, 2024 Published online: October 27, 2024 Processing time: 113 Days and 3.5 Hours
Abstract
BACKGROUND
Thrombocytopenia is a common complication of invasive liver abscess syndrome (ILAS) by Klebsiella pneumoniae (K. pneumoniae) infection, which indicates severe infection and a poor prognosis. However, the presence of leukopenia is rare. There are rare reports on leukopenia and its clinical significance for ILAS, and there is currently no recognized treatment plan. Early and broad-spectrum antimicrobial therapy may be an effective therapy for treating ILAS and improving its prognosis.
CASE SUMMARY
A 55-year-old male patient who developed fever, chills, and abdominal distension without an obvious cause presented to the hospital for treatment. Laboratory tests revealed thrombocytopenia, leukopenia, and multiple organ dysfunction. Imaging examinations revealed an abscess in the right lobe of the liver and thrombophlebitis, and K. pneumoniae was detected in the blood cultures. Since the patient was diabetic and had multi-system involvement, he was diagnosed with ILAS accompanied by leukopenia and thrombocytopenia. After antibiotic treatment and systemic supportive therapy, the symptoms disappeared, and the patient’s condition almost completely resolved.
CONCLUSION
Leukopenia is a rare complication of ILAS, which serves as an indicator of adverse prognostic outcomes and the severity of infection.
Core Tip: Thrombocytopenia is a common complication of invasive liver abscess syndrome (ILAS). However, there have been no reports of concurrent leukopenia with ILAS so far. This patient presented with a sustained high fever, abdominal distension, and pain after hospitalization. He subsequently developed multiple organ and system dysfunction, as well as an atypical leukopenia coexisting with thrombocytopenia. These features are often used as indicators of the severity of the disease. Klebsiella pneumoniae was detected on blood cultures, and antibiotics were adjusted timely based on drug sensitivity test results. After systemic support and blood glucose management treatment, the patient’s condition resolved. Early antimicrobial therapy is an effective measure to control infection and improve prognosis.
