Liang ZJ, Liang JK, Chen YP, Chen Z, Wang Y. Primary liver actinomycosis in a pediatric patient: A case report and literature review. World J Clin Cases 2021; 9(20): 5717-5723 [PMID: 34307630 DOI: 10.12998/wjcc.v9.i20.5717]
Corresponding Author of This Article
Yong Wang, MD, Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China. summer0660@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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 Clin Cases. Jul 16, 2021; 9(20): 5717-5723 Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5717
Primary liver actinomycosis in a pediatric patient: A case report and literature review
Zi-Jian Liang, Jian-Kun Liang, Yun-Pei Chen, Zhen Chen, Yong Wang
Zi-Jian Liang, Jian-Kun Liang, Yun-Pei Chen, Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Zhen Chen, Department of Radiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Yong Wang, Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
Author contributions: Liang ZJ and Liang JK are co-first authors and contributed equally to this study; Liang ZJ and Wang Y contributed to study conception and design; Liang ZJ and Liang JK acquired the data; Liang ZJ, Liang JK and Chen Z analyzed and interpreted data; Liang ZJ, Liang JK, and Chen YP wrote the manuscript; Liang ZJ and Chen YP revised the manuscript; all authors read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81800448.
Informed consent statement: Written informed consent was obtained from the patient’s legal guardian(s) for the publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Wang, MD, Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China. summer0660@163.com
Received: March 11, 2021 Peer-review started: March 11, 2021 First decision: March 25, 2021 Revised: April 19, 2021 Accepted: May 24, 2021 Article in press: May 24, 2021 Published online: July 16, 2021
Abstract
BACKGROUND
Primary hepatic actinomycosis is a rare infection that can be clinically confused with hepatic pyogenic abscesses or neoproliferative processes. Only a few cases of primary hepatic actinomycosis in children have been reported in the English literature.
CASE SUMMARY
We describe a pediatric patient with primary hepatic actinomycosis that involved the base of the right lung and anterior abdominal wall and skin. The patient was diagnosed via histological examination of spontaneously drained material. The patient was successfully treated with an exploratory laparotomy and right posterior segmentectomy of the liver, combined with antibiotic treatment. Following surgery, the patient remains in excellent condition, without evidence of recurrence at the time of drafting this report. To summarize the clinical manifestations, diagnosis, treatment, and outcomes of primary hepatic actinomycosis, 18 case reports in English were reviewed.
CONCLUSION
We conclude that actinomycosis clinically features a chronic onset, nonspecific symptoms, and a primarily histologic diagnosis. Prolonged antibiotic treatment combined with invasive intervention provides a good prognosis.
Core Tip: Actinomyces are considered natural commensals in the gastrointestinal tract and seldom involved in abdominal infection. We present herein a rare pediatric case of primary hepatic actinomycosis that involved a pulmonary abscess and the anterior abdominal wall and skin. In our case, after diagnosis is made histologically, we chose cefoperazone sulbactam as the main antibiotic treatment which eventually led to a good prognosis when combined with invasive intervention. This case highlights the ultimate importance of early suspect on special infection when normal antibiotic treatment failed and proper antibiotic treatment with surgery are essential in successful treatment for actinomycosis.
