An Atypical Presentation of a Pyogenic Liver Abscess Caused by Fusobacterium nucleatum Post-ruptured Appendix

Hinal Rathi; Faraeha Fatima; Taimoor Hassan; Kiely Schultz

doi:10.7759/cureus.42895

An Atypical Presentation of a Pyogenic Liver Abscess Caused by Fusobacterium nucleatum Post-ruptured Appendix

Cureus. 2023 Aug 3;15(8):e42895. doi: 10.7759/cureus.42895. eCollection 2023 Aug.

Authors

Hinal Rathi¹, Faraeha Fatima², Taimoor Hassan², Kiely Schultz²

Affiliations

¹ Internal Medicine, Arkansas College of Osteopathic Medicine, Fort Smith, USA.
² Internal Medicine, Parkview Medical Center Internal Medicine Residency Program, Pueblo, USA.

Abstract

A rare formation of a pyogenic liver abscess can be found in patients with a ruptured appendix. Here, we discuss a 49-year-old male with a past medical history significant for drug-induced pancreatitis from metformin, type II diabetes, obesity, and hypertension who presented with right upper quadrant pain. He was diagnosed with a 12.6 cm pyogenic liver abscess. Upon further chart review, the patient had a laparoscopic appendectomy done nine months ago, with the findings of a ruptured appendix. The liver abscess cultures grewFusobacterium nucleatum - a common culprit of acute appendicitis reported in several case studies and clinical trials. This case report highlights the importance of including appendectomy as an essential part of history-taking and diagnostic differential for pyogenic liver abscesses.

Keywords: appendicitis; fusobacterium liver abscess; fusobacterium nucelatum; fusobacterium treatment; pyogenic abscess.

Publication types

Case Reports