Work

Bacteraemia with hepatic abscess due to Actinomyces odontolyticus associated with gastrointestinal foreign body

Year: 2025

Type: article

Abstract: Background: , as evidenced by both positive blood culture and abscess fluid culture, associated with a perforating foreign body from a fish bone. Case report: by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. After percutaneous drainage, the patient's abdominal pain increased. Contrast-enhanced computed tomography scan revealed a fish bone foreign body penetrating from the duodenum into the liver. The patient underwent laparoscopic surgery for foreign body removal and abscess drainage, followed by treatment with intravenous piperacillin/tazobactam for 21 days, then oral amoxicillin/clavulanate for 3 weeks. The patient was discharged in stable condition. Conclusion: This case emphasizes the importance of computed tomography scan when a liver abscess does not respond to conventional treatment, especially in elderly patients with dementia at risk of foreign body ingestion. Actinomyces spp. should be considered in cases of liver abscess of unknown aetiology. LEARNING POINTS: should be considered: In cases of liver abscess of unknown aetiology, Actinomyces spp. should be considered - a slow-growing anaerobic bacterium requiring matrix-assisted laser desorption/ionization matrix-assisted laser desorption/Ionization time-of-flight mass spectrometry for accurate species identification and targeted antibiotic therapy guidance.Combined treatment is the key to success: Optimal management requires a combination of three elements - surgical removal of the foreign body, thorough abscess drainage, and prolonged beta-lactam antibiotics to prevent recurrence.

Source: European Journal of Case Reports in Internal Medicine

DOI: 10.12890/2025_005985

Authors: Van Duyet Nguyen, Viet Nghia Le, Quoc Phuong Nguyen, Thi Dung Le

Institutions: Hanoi Medical University, Hanoi Medical University Hospital

Language: English

Topic: Actinomycetales infections and treatment

Subfield: Microbiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $323