糖尿病に合併したガス産生性巨大肝膿瘍の1例

Abstract

We report the case ofa 52-year-old woman who developedalarge gas- forming pyogenic liver abscess. She had complaints of fever for 8 days with a dull pain in the right upper quadrant of the abdomen. An emergent blood examination revealed leukocytosis (white blood cells 20210/μl), abnormal liver function including elevated transaminase and alkaline phosphatase values (AST 675 IU/L, ALT 359 IU/L, ALP 1083 U/L) and high glucose level (435 mg/dl). Although she was once notified of a elevated serum glucose level at her pregnancy 15 years before, no further examinations had been done until the present occasion. The diagnosis of gas-forming liver abscess was easily made by abdominal ultrasonography and computed tomography. The patient was successfully treated with intravenous administration of appropriate antibiotics following immediate percutaneous transhepatic abscess drainage (PTAD). Klebsiella Pneumoniae (K. Pneumoniae) was detected in a specimen from the PTAD tube. Liver abscess caused by K. Pneumoniae should be considered as an infectious complication in diabetic patients.