SHM Converge Scientific Abstract ePoster Gallery-The Tooth About Liver

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This case report describes a rare hepatic abscess caused by <strong>Parvimonas micra</strong>, an anaerobic bacterium normally found in the oral cavity and gastrointestinal tract. Although generally a commensal organism, P. micra can cause serious invasive infection, including liver abscesses.

The patient was a <strong>69-year-old woman</strong> with hypertension and arthritis who presented with <strong>2 weeks of myalgias, poor appetite, malaise, and fevers</strong>, plus a brief episode of non-bloody diarrhea. She had no recent travel, dental or abdominal procedures, or livestock exposure. Her exam was unremarkable, but labs showed <strong>leukocytosis (WBC 22)</strong> and elevated liver enzymes and alkaline phosphatase. CT imaging revealed a <strong>large multiloculated left hepatic cystic lesion</strong> with peripheral enhancement, consistent with abscess.

She underwent <strong>pigtail catheter drainage</strong>, and cultures from the abscess grew <strong>P. micra</strong>. She was treated with <strong>3 weeks of IV ampicillin-sulbactam</strong>, followed by <strong>2 additional weeks of clindamycin</strong>.

The report emphasizes that P. micra abscesses are difficult to diagnose because the organism grows slowly, may cause few specific symptoms, and often requires special culture methods. Reported risk factors include <strong>poor hygiene, social isolation, low socioeconomic status, and immunocompromise</strong>. Without timely antibiotics and drainage, hepatic abscesses can be fatal. However, prognosis is generally good when the abscess is adequately drained and there is no underlying malignancy.

The authors also stress the importance of a <strong>thorough evaluation for an underlying primary cancer</strong>, since liver abscesses can occasionally be associated with occult malignancy.

Asset Subtitle

Tai Do

Meta Tag

Author List Folasade Arinze, Tai Do

Category Clinical Vignettes

Concept Parvimonas micra

Concept Pyogenic Hepatic Abscess

Concept Empiric Antibiotic Therapy

Concept Percutaneous Drainage

Concept Clinical Presentation

Distinguished Non-Finalist

Presenter Organization WellStar Kennestone RMC

Presenting Author Tai Do

Track Adult

Keywords

Parvimonas micra

hepatic abscess

liver abscess

anaerobic bacterium

pigtail catheter drainage

ampicillin-sulbactam

clindamycin

leukocytosis

occult malignancy

immunocompromise

Parvimonas micra

Pyogenic Hepatic Abscess

Empiric Antibiotic Therapy

Percutaneous Drainage

Clinical Presentation