Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7082
Peer-review started: December 17, 2021
First decision: January 26, 2022
Revised: February 10, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: July 16, 2022
Processing time: 199 Days and 13.9 Hours
Pyogenic liver abscesses are insidious in the early stage. Some cases progress rapidly, and the patient’s condition can worsen and even become life-threatening if timely treatment is not provided. Surgery and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the lumen.
We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment, review the literature related to the use of platelet-rich plasma (PRP) in the treatment of hepatic impairment and partial hepatectomy in animals, and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver abscesses. This is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans, providing new ideas for the treatment of this condition.
This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed medically. PRP may produce antimicrobial effects and promote the regeneration and repair of liver tissue.
Core Tip: Previously, pyogenic liver abscesses were typically treated with antibacterial drugs, percutaneous puncture and drainage, or surgical incision and drainage; treatment by surgical incision and drainage combined with platelet-rich plasma (PRP) has not been reported. By reviewing the relevant literature and combining the previously reported benefits of PRP on liver function improvement and liver tissue regeneration and repair, we treated a large abscess with complete liquefaction and a poor response to antibacterial drug treatment by surgical incision and drainage combined with PRP at our hospital. The patient was discharged after 7 d of treatment without pus cavity flushing and with no recurrence during follow-up. Therefore, we consider that PRP may have direct antimicrobial and promotional effects on liver tissue regeneration, but this needs to be confirmed in a clinical case–control study with a larger sample.