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Liver abscess in human toxocariasis

V. Treska, A. Sutnar, P. Mukensnabl, T. Manakova, D. Sedlacek, H. Mirka, J. Ferda

. 2011 ; 112 (11) : 644-647.

Language English Country Slovakia

Document type Case Reports, Journal Article, Research Support, Non-U.S. Gov't

Grant support
NS10240 MZ0 CEP Register
NS9727 MZ0 CEP Register

BACKGROUND: Toxocariasis is a parasitic infection caused by Toxocara canis or Toxocara cati. It is distributed worldwide. Liver is the main organ affected by Toxocara infection, typically with multiple eosinophilic infiltrates. Liver abscess formation is a very rare condition. METHOD: The authors report on a case of Toxocariasis infection with abscess formation in the right liver lobe. The diagnosis was made upon patient's history, clinical examination, use of ultrasonography, computed tomography and especially upon positive serologic test and hypereosinophilia. After unsuccessful conservative treatment (Mebendazole, antibiotics and corticoids), right hepatectomy was performed. RESULTS: The postoperative course was complicated by biliary fistula in the resection area. The complication was successfully managed by temporary stent implantation to the left hepatic duct. Six months after the operation, the patient is with no complications. CONCLUSION: Liver abscess formation is a rare condition associated with Toxocara infection. It is still a matter of debate whether liver abscess results from severe parasitic infection or whether human toxocariasis is a predisposing cause of pyogenic liver abscess formation. Liver resection is the only treatment option when sepsis fails to respond to conservative treatment (Fig. 5, Ref. 22).

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$a BACKGROUND: Toxocariasis is a parasitic infection caused by Toxocara canis or Toxocara cati. It is distributed worldwide. Liver is the main organ affected by Toxocara infection, typically with multiple eosinophilic infiltrates. Liver abscess formation is a very rare condition. METHOD: The authors report on a case of Toxocariasis infection with abscess formation in the right liver lobe. The diagnosis was made upon patient's history, clinical examination, use of ultrasonography, computed tomography and especially upon positive serologic test and hypereosinophilia. After unsuccessful conservative treatment (Mebendazole, antibiotics and corticoids), right hepatectomy was performed. RESULTS: The postoperative course was complicated by biliary fistula in the resection area. The complication was successfully managed by temporary stent implantation to the left hepatic duct. Six months after the operation, the patient is with no complications. CONCLUSION: Liver abscess formation is a rare condition associated with Toxocara infection. It is still a matter of debate whether liver abscess results from severe parasitic infection or whether human toxocariasis is a predisposing cause of pyogenic liver abscess formation. Liver resection is the only treatment option when sepsis fails to respond to conservative treatment (Fig. 5, Ref. 22).
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$a Sutnar, A. $u Department of Surgery, School of Medicine, University Hospital, Pilsen, Czech Republic
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$a Mukensnabl, P. $u Radiodiagnostic Clinic of the Faculty Hospital and Faculty of Medicine, Charles University in Pilsen, Czech Republic
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$a Manakova, T. $u Radiodiagnostic Clinic of the Faculty Hospital and Faculty of Medicine, Charles University in Pilsen, Czech Republic
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$a Sedlacek, D. $u Department of Surgery, School of Medicine, University Hospital, Pilsen, Czech Republic
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$a Mirka, H. $u Radiodiagnostic Department, School of Medicine, University Hospital, Pilsen, Czech Republic
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