Successful transcatheter arterial antimicrobial and steroid therapy for refractory liver abscess in chronic granulomatous disease: A case report and review of literature

J Infect Chemother. 2018 Mar;24(3):224-227. doi: 10.1016/j.jiac.2017.10.011. Epub 2017 Nov 10.

Abstract

Hepatic abscess in chronic granulomatous disease (CGD) is very refractory and frequently requires multiple surgeries with frequent morbidities. Although surgical interventions are often required, patients are often not able to have surgery for various reasons. We present the case of a 21-year-old man with recurrent hepatic abscess in CGD. We could not provide surgical interventions due to the lack of a fluid cavity and the patient's refusal, and therefore we administered transcatheter arterial antimicrobial and steroid therapy. He did not have any exacerbation for more than 18 months after the final transcatheter treatment. This is the first reported case of successful transcatheter arterial antimicrobial and steroid therapy for refractory hepatic abscess in CGD. Although the patient's burden and medical cost were not inconsequential, this case shows that the transcatheter arterial antimicrobial and steroid therapy may be a treatment option for patients who are not candidates for surgical interventions.

Keywords: Chronic granulomatous disease; Liver abscess; Transcatheter arterial therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Catheterization, Peripheral / methods*
  • Granulomatous Disease, Chronic / drug therapy*
  • Granulomatous Disease, Chronic / genetics
  • Humans
  • Liver / pathology
  • Liver Abscess / diagnostic imaging
  • Liver Abscess / drug therapy*
  • Male
  • NADPH Oxidase 2 / genetics
  • Recurrence
  • Steroids / therapeutic use*
  • Young Adult

Substances

  • Anti-Infective Agents
  • Steroids
  • CYBB protein, human
  • NADPH Oxidase 2