Clostridium perfringensLiver Abscess after Pancreatic Resection
| Autor: | Ingrid Stelzmueller, Hugo Bonatti, Manfred Cejna, Gabriele Hartmann, Walther Tabarelli, Etienne Wenzl |
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| Rok vydání: | 2009 |
| Předmět: |
Microbiology (medical)
Tazobactam medicine.medical_specialty medicine.medical_treatment Liver Abscess Penicillanic Acid Antineoplastic Agents Bacteremia medicine.disease_cause Sepsis Fatal Outcome Pancreatectomy Postoperative Complications Pancreatic cancer medicine Humans Aged Piperacillin biology business.industry Cancer Explorative laparotomy Clostridium perfringens medicine.disease biology.organism_classification Neoadjuvant Therapy Anti-Bacterial Agents Surgery Pancreatic Neoplasms Infectious Diseases Streptococcus oralis Liver Clostridium Infections Female business Liver abscess |
| Zdroj: | Surgical Infections. 10:159-162 |
| ISSN: | 1557-8674 1096-2964 |
| DOI: | 10.1089/sur.2008.014 |
| Popis: | Liver abscess is a rare complication after pancreatectomy. Clostridium perfingens is a rare cause of intrahepatic infections.A 65-year-old woman with pancreatic cancer underwent explorative laparotomy, during which encasement of the hepatic artery by the tumor was found. Neoadjuvant radiochemotherapy with capecitabine was started, which caused tumor regression, and duodenopancreatectomy was performed. The portal vein was occluded and infiltrated by cancer and therefore was resected and not reconstructed. After a slow recovery, the patient developed hemorrhage at the gastrojejunal anastomosis, which was controlled by fibrin injection. Within a few days, she presented with signs of sepsis, and blood cultures yielded Clostridium perfringens, Streptococcus oralis, Staphylococcus aureus, and Candida albicans. The source of the sepsis proved to be a 9-cm liver abscess, which was drained; cultures grew C. perfringens, Hafnia alvei, and Enterobacter cloacae. Despite antibiotic treatment, the patient died from sepsis and multiorgan failure 27 days after pancreatic surgery.Such rare infections can follow pancreatic resection with neoadjuvant radiochemotherapy. Clostridium perfringens-associated liver abscess maintains a high mortality rate. |
| Databáze: | OpenAIRE |
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