Images in Clinical Medicine
Liver Abscess Due to Eikenella corrodens from a Fishbone
N Engl J Med 2001; 345:e5December 6, 2001
- Article
Figure 1 A 53-year-old man presented with a four-week history of abdominal pain and a tender, nonerythematous mass (5 by 5 cm) in the right upper quadrant. He had a temperature of 36.3°C, a leukocyte count of 8100 per cubic millimeter, and normal liver-function tests. A computed tomographic (CT) scan showed a mass in the left lobe of the liver with a thin, linear calcification and invasion beyond the capsule to the abdominal wall. The linear density within the abscess (arrow) was initially thought to be an artifact. A CT-guided biopsy led to drainage of 14 ml of purulent fluid; a Gram's stain of the fluid showed gram-positive cocci in clusters, pairs, and chains and gram-positive and gram-negative rods. Treatment was initiated with intravenous vancomycin and piperacillin–tazobactam. When the patient's condition did not improve, surgical drainage led to the discovery of a thin fishbone in the abscess. The cultures grew Eikenella corrodens, an organism typically associated with human bites, which was presumably acquired from the patient's oral cavity while he was eating fish. The fishbone apparently penetrated the wall of the first portion of the duodenum and passed through the posterior surface of the liver to the left lobe, near the abdominal wall. The patient's condition rapidly improved after the foreign body was removed, and he was discharged while taking oral amoxicillin–clavulanate. He recalled taking a fishing trip three months earlier, but he had no recollection of ingesting the fishbone.
Alexander Tkeshelashvili Kessler, M.D.
Athena P. Kourtis, M.D., Ph.D.
Emory University School of Medicine, Atlanta, GA 30303- Citing Articles (10)
Citing Articles
1
Nicola Leggieri, Pedro Marques-Vidal, Herwig Cerwenka, Alban Denys, Gian Dorta, Vincent Moutardier, Didier Raoult. (2010) Migrated Foreign Body Liver Abscess. Medicine 89:2, 85-95
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H. J. R. Bonatti, J. Stauffer, N. Turan, H. Goegele, C. D. Sifri, K. Martin, R. Hinder, J. H. Nguyen. (2010) Liver abscess due to Eikenella corrodens, Prevotella meloninogenica, and Lactobacillus spp. following pancreatoduodenectomy: Case report and review of the literature. European Surgery 42:1, 58-64
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A. Ambrosi, F.P. Prete, V. Neri, E. Ierardi. (2007) Pseudotumoural lesion of the abdominal wall due to a fishbone migration. Digestive and Liver Disease 39:4, 368
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Nefise Öztoprak, Ülkü Bayar, Güven Çelebi, Mustafa Basaran, Füsun Cömert. (2007) Eikenella Corrodens, Cause of a Vulvar Abscess in a Diabetic Adult. Infectious Diseases in Obstetrics & Gynecology 2007, 1-2
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Wendy K. Foster, Julie A. Armstrong. (2006) Hypertrophic osteopathy associated with pulmonary Eikenella corrodens infection in a dog. Journal of the American Veterinary Medical Association 228:9, 1366-1369
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CrossRef8
Brice Dugas, Bénédicte Bernard, Emmanuel Odet, Alain Naouri, Pierre Bernard, Pierre-Jean Valette. (2005) BAD DENTITION AND RISK OF JEJUNAL PERFORATION BY FISH BONE. Journal of the American Geriatrics Society 53:9, 1632-1633
CrossRef9
M. Nisbet, M. Thomas, P. A. Mackowiak. (2005) Liver Abscess Associated with Persistent Streptococcus anginosus Bacteremia. Clinical Infectious Diseases 41:3, 403-405
CrossRef10
Karl Y. Bilimoria, Roger K. Eagan, Douglas K. Rex. (2003) Colonoscopic Identification of a Foreign Body Causing an Hepatic Abscess. Journal of Clinical Gastroenterology 37:1, 82-85
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