Castelijn, D. A. R.

Doorenbos, C. R. C.

Kropff, J.

Vreden, S. G.

English

University of Groningen

   University of GroningenSepticaemia and liver abscesses after a skin ulcer in the tropicsCastelijn, D. A. R.; Vreden, S. G.; Doorenbos, C. R. C.; Kropff, J.Published in:Netherlands Journal of MedicineIMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2020Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Castelijn, D. A. R., Vreden, S. G., Doorenbos, C. R. C., & Kropff, J. (2020). Septicaemia and liverabscesses after a skin ulcer in the tropics. Netherlands Journal of Medicine, 78(5), 303.http://www.njmonline.nl/article_ft.php?a=2255&d=1472&i=236CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 29-04-2023303S E P T E M B E R  2 0 2 0 ,  V O L .  7 8 ,  N O .  5© MacChain. All rights reserved.The Netherlands Journal of MedicineP H O T O  Q U I ZSepticaemia and liver abscesses after a skin ulcer in the tropicsD.A.R. Castelijn1*, S.G. Vreden2, C.R.C. Doorenbos3, J. Kropff41Department of Internal Medicine, Amsterdam UMC, location VU University Medical Centre, Amsterdam, the Netherlands; 2Department of Internal Medicine, Academic Hospital Paramaribo, Paramaribo, Suriname; 3Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands; 4Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.  *Corresponding author: d.castelijn@amsterdamumc.nlC A S E  R E P O R TA 40-year-old, previously healthy man presented to the internal medicine outpatient clinic in Paramaribo, Suriname with a six-week history of intermittent fever. Approximately four days prior to onset of his fever, he had waded through stagnant, fresh water with a leg wound caused by blunt force trauma. Physical examination revealed a non-septic patient with pain in the right upper abdomen and a healing skin ulcer on the left shin (figure 1). Laboratory results showed evident inflammation with leucocytosis 21.9 x 109/l [4.5-11 x 109/l] and C-reactive protein 285 mg/l [0-5 mg/l]. Liver enzymes were normal and HIV screening was negative. Abdominal CT scan showed multiple liver abscesses, the largest was 41 mm in diameter (figure 2A). Because of the subpleural localisation of this abscess, drainage was deemed too risky. Culture of aspirated pus showed growth of a single species of bacteria with a distinct violet pigment (figure 2B). The blood culture yielded the same microorganism. What is your diagnosis?W H A T  I S  Y O U R  D I A G N O S I S ?See page 304 for the answer to this photo quiz.Figure 1. A healing skin ulcer  (3 x 1 cm) on the left shin, caused by blunt force traumaFigure 2A. Transversal CT image showing a hypodense lesion suggestive of  liver abscessFigure 2B. Culture of the pus aspiration demonstrating a distinctive violet-pigmented, bacterial colony on a chocolate agar plate

Septicaemia and liver abscesses after a skin ulcer in the tropics

https://pure.rug.nl/ws/files/157613481/getpdf_4_.pdf

Septicaemia and liver abscesses after a skin ulcer in the tropics

Abstract

Similar works

Full text

Available Versions

University of Groningen