Fakhriya Alalawi, Hind AlNour, Bridson M Julie, Ajay Sharma and Ahmed Halawa
Intra-abdominal and biliary infections are significant cause of morbidity and mortality for the transplant recipients, specifically in the early post-operative period, reflecting substantial immunosuppression. In renal transplant recipients, there is no reported increased risk for pyogenic liver abscess as compared to general population. The diagnosis of hepatic abscess in a transplant recipient can be challenging since presentation could be atypical and the signs and symptoms might be insidious and subtle. If a hepatic abscess is missed and left untreated, it is potentially lethal; hence, an early diagnosis and timely initiation of appropriate therapy is of utmost importance, to improve patient outcomes.
We present a case record of a 29 year old male patient who received a living unrelated renal transplant in 2007. He presented 8 years post-transplant with a fever of unknown origin; clinical and laboratory tests did not provide any clue to the diagnosis. However, labeled white cell scan (Leukoscan) followed by abdominal ultrasound scan (USS) revealed an unexpected finding of a large liver abscess (5.57 × 6.05 cm). He responded well to a course of antibiotics including metronidazole therapy besides requiring percutaneous abscess drainage.
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