A rare presentation of a retroperitoneal liver and kidney abscess: a case report

Abstract

Introduction:  Liver abscess as well as kidney abscess is an uncommon condition, associated with multiple etiologies and its occurrence can lead to serious infectious conditions or even death. Those two entities occurring simultaneously is a rare condition. The quick identification and implementation of appropriate treatment is essential for mitigate sequelae.  The article describes a case of a 45-year-old woman with a history of nephrolithiasis and recurrent pyelonephritis in the right kidney who was admitted to a tertiary hospital in Rio de Janeiro with abdominal pain in the right hypochondrium, nausea, vomiting and recent history of fever.  Discussion: Laboratory changes were observed such as anemia, leukocytosis with left shift, elevated creatinine and CRP, in addition to positive urine culture for E. Coli ESBL.  As the condition worsened, an exploratory laparotomy was performed, which revealed an abscess in hepatorenal cavity in segment VI. The culture of the peritoneal fluid and the collection revealed the presence of E. coli ESBL, such as the urine culture. The present case report aims to describe a severe presentation of bacterial liver abscess, in addition to providing a review of the literature on the different etiologies and clinical symptoms of this condition.  Conclusion: It can be seen, therefore, that the liver abscess may have originating from a renal infectious focus that spread contiguously or via hematogenous to the liver.  There is still the possibility that the long period of use of the double J catheter may have favored and/or perpetuated the disease