Published in:
01-07-2018 | Imaging in Intensive Care Medicine
En route to the liver: an fishbone’s unexpected journey
Published in: Intensive Care Medicine | Issue 7/2018
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A 73-year-old female was admitted to the ICU for sepsis. She described profound fatigue for 1 month, with chills and flu-like symptoms. At the emergency department, she presented septic shock. The abdominal CT scan showed a 9 × 8.5-cm left liver abscess, with an aeric image and a spontaneously hyperdense foreign body 35 mm inside. The duodenum wall was significantly thickened (Figs. 1, 2). Blood cultures revealed a Streptococcus alpha hemolyticus and Lactobacillus rhamnosus bacteriemia, while percutaneous drainage allowed the evacuation of 500 ml purulent fluid. Microbiologic culture showed colonies of Lactobacillus rhamnosus, Streptococcus intermedius, Streptococcus anginus, Granulicatella adiacens and Actinomyces odontolyticus. Antibiotic therapy was modified from cefotaxime to piperacillin/tazobactam, and the evolution was favorable.
Fig. 1
Abdominal CT scan. Abdominal CT scan with contrast injection visualizing the liver abscesses and a spontaneously hyperdense foreign body
Fig. 2
Abdominal CT scan
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