Liver abscess caused by Cutibacterium namnetense after transarterial chemoembolization for hepatocellular carcinoma
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CASE REPORT
Liver abscess caused by Cutibacterium namnetense after transarterial chemoembolization for hepatocellular carcinoma Eiichiro Yasutomi1 · Yoshihide Ueda1 · Naoki Asaji1 · Atsushi Yamamoto1 · Ryutaro Yoshida1 · Yuri Hatazawa1 · Hiroki Hayashi1 · Yuuki Shiomi1 · Yoshihiko Yano1 · Yuzo Kodama1 Received: 30 July 2020 / Accepted: 21 October 2020 © Japanese Society of Gastroenterology 2020
Abstract A 72-year-old man underwent transarterial chemoembolization (TACE) for solitary hepatocellular carcinoma (HCC) located on the S6 segment. He had a history of anti-viral therapy for hepatitis C virus and was being treated for diabetes mellitus with inadequate control. On day 28 after TACE, he visited our hospital again, with complaints of fever and abdominal pain in the right upper quadrant. Blood examination showed elevated levels of white blood cells and C-reactive protein. Computed tomography showed a poorly marginated, low-density lesion measuring 9.5 × 8.0 × 4.0 cm, forming multiple small gas bubbles, located superiorly, and in contact with HCC treated by TACE. Ultrasound-guided puncture revealed whiffy and muddy pus. Gram staining of the pus showed the presence of numerous gram-positive rods, which were identified as Cutibacterium namnetense. He underwent percutaneous trans-hepatic abscess drainage and received antibiotics treatment. The abscess was successfully treated, and he was discharged on day 19. The incidence of liver abscess after TACE is rare, and intestinal microbiota have been reported to be the common pathogens. To the best of our knowledge, this is the first case of liver abscess caused by Cutibacterium namnetense. Keywords Liver abscess · Transarterial chemoembolization · Cutibacterium namnetense
Introduction Hepatocellular carcinoma (HCC) is the sixth most common cancer type globally [1]. With recent developments in the therapeutic options for HCC, the 5-year survival rate of HCC in Japan has improved from 39.7% in 1994–2001 to 50.4% in 2002–2009 [2]. Among the treatment methods for HCC, transarterial chemoembolization (TACE), which is an interventional radiology procedure where chemotherapeutic and embolic agents are delivered into a tumor body, has been playing an important role in extension of prognosis through evolution of new drugs and advancing techniques [3]. However, complications associated with TACE are currently attracting attention. One of them is liver abscess, occurring in 0.1–4.5% patients [4]. The common pathogens * Yuzo Kodama [email protected]‑u.ac.jp 1
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7‑5‑1 Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo 650‑0017, Japan
found in liver abscess after TACE have been reported to be intestinal microbiota, concretely, Escherichia coli, Enterobacter cloacae, Enterococcus faecalis, and Klebsiella pneumoniae, among others [4, 5]. In this report, we experienced a case of liver abscess after TACE caused by Cutibacterium namnetense [6], a recently identified skin microbiota. This case w
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