Hepatic cyst infection as a source of sepsis in liver polycystosis

Česká verzia

Authors: G. Růžičková; L. Gabalec
Authors place of work: Interní oddělení – Endoskopie, Orlickoústecká nemocnice, Nemocnice Pardubického kraje, a. s., Ústí nad Orlicí
Published in the journal: Gastroent Hepatol 2018; 72(2): 122-128
Category: Hepatologie: kazuistika
doi: https://doi.org/10.14735/amgh2018122

Summary

Liver cysts are commonly identified by imaging methods. Polycystic liver disease is diagnosed when there are ten or more cysts and often develops as part of polycystic kidney disease or an isolated polycystic liver disorder. This disease is usually asymptomatic and does not require treatment. Impairment of renal function is one of the main symptoms in patients with cystic kidney disease. Complications of polycystosis, such as cyst bleeding, portal hypertension, icterus, and hepatic failure, are rare. A hepatic cyst infection that requires both antibiotic therapy and radiological or surgical intervention is a serious complication due to the high failure rate of separate antibiotic therapy. Quinolones are the recommended antibiotic therapy. Medications, such as somatostatin analogues, mTOR inhibitors, and ursodeoxycholic acid, have only been used in clinical trials. Arterial embolization of the hepatic artery or percutaneous aspiration and subsequent sclerotherapy of the cyst can aid interventional radiology. Several clinical classifications listed in this article can help clinicians decide whether to perform surgical therapy or liver transplantation. We present the case of a 60-year-old man with hereditary polycystosis of the kidneys and liver who was treated for sepsis due to hepatic cyst infection. Although parenteral antibiotic therapy reduced his fever and improved his laboratory findings, improvement of subjective problems occurred after the radiological intervention. Due to disease progression and the risk of the cyst infection recurring, the patient attended a consultation at a transplant center and liver transplantation was indicated.

Key words:
polycystic liver disease – sepsis – antibiotic therapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
5. 1. 2018

Accepted:
8. 2. 2018

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