Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2018; 10(3): 388-395
Published online Mar 27, 2018. doi: 10.4254/wjh.v10.i3.388
Clostridium paraputrificum septicemia and liver abscess
Yong K Kwon, Faiqa A Cheema, Bejon T Maneckshana, Caroline Rochon, Patricia A Sheiner
Yong K Kwon, Faiqa A Cheema, Bejon T Maneckshana, Caroline Rochon, Patricia A Sheiner, Department of Transplant, Hartford Hospital, Hartford, CT 06106, United States
Author contributions: Kwon YK and Cheema FA wrote the initial manuscript; Maneckshana BT, Rochon C and Sheiner PA performed a literature search and analyzed the data; all authors contributed equally to editing and revising the final manuscript.
Informed consent statement: Written informed consent and permission to write this manuscript was obtained from the patient of this case report.
Conflict-of-interest statement: The authors certify that we have no conflict of interest to disclose and did not receive any financial support for this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yong K Kwon, MD, Assistant Professor of Surgery, Department of Transplant, Hartford Hospital, 85 Seymour Street, Suite 320, Hartford, CT 06106, United States. yong.kwon@hhchealth.org
Telephone: +1-860-6962030 Fax: +1-860-5491476
Received: December 19, 2017
Peer-review started: December 20, 2017
First decision: January 23, 2018
Revised: January 30, 2018
Accepted: March 1, 2018
Article in press: March 1, 2018
Published online: March 27, 2018
Processing time: 97 Days and 13 Hours
Abstract

We report the first case of a healthy 23-year-old female who underwent an interventional radiology-guided embolization of a hepatic adenoma, which resulted in a gas forming hepatic liver abscess and septicemia by Clostridium paraputrificum. A retrospective review of Clostridial liver abscesses was performed using a PubMed literature search, and we found 57 clostridial hepatic abscess cases. The two most commonly reported clostridial species are C. perfringens and C. septicum (64.9% and 17.5% respectively). C. perfringens cases carried a mortality of 67.6% with median survival of 11 h, and 70.2% of the C. perfringens cases experienced hemolysis. All C. septicum cases were found to have underlying liver malignancy at the time of the presentation with a mortality of only 30%. The remaining cases were caused by various Clostridium species, and this cohort’s clinical course was significantly milder when compared to the above C. perfringens and C. septicum cohorts.

Keywords: Clostridium; Hemolysis; Liver cell adenoma; Morbidity; Mortality; Pyogenic liver abscess

Core tip: To our best knowledge, this is the first case where a liver abscess grew C. paraputrificum. Although pyogenic liver abscesses caused by Clostridium species are extremely rare, early and accurate diagnosis of clostridial hepatic abscess and timely interventions are paramount, as it carries an extremely high morbidity and mortality. However, depending on the exact causative Clostridium species, the clinical course can vary unexpectedly.