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Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report.

Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report.
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Takano Y, Hayashi M, Niiya F, Nakanishi T, Hanamura S, Asonuma K, Yamamura E, Gomi K, Kuroki Y, Maruoka N, Inoue K, Nagahama M,


Takano Y, Hayashi M, Niiya F, Nakanishi T, Hanamura S, Asonuma K, Yamamura E, Gomi K, Kuroki Y, Maruoka N, Inoue K, Nagahama M, (click to view)

Takano Y, Hayashi M, Niiya F, Nakanishi T, Hanamura S, Asonuma K, Yamamura E, Gomi K, Kuroki Y, Maruoka N, Inoue K, Nagahama M,

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BMC research notes 2017 03 0610(1) 117 doi 10.1186/s13104-017-2445-8
Abstract
BACKGROUND
Emphysematous liver abscesses are defined as liver abscesses accompanied by gas formation. The fatality rate is extremely high at 27%, necessitating prompt intensive care.

CASE PRESENTATION
The patient was a 69-year-old Japanese man with type 2 diabetes. He visited the emergency outpatient department for fever and general malaise that had been ongoing for 2 weeks. Abdominal computed tomography revealed an abscess 5 cm in diameter accompanied by gas formation in the right hepatic lobe. Markedly impaired glucose tolerance was observed with a blood sugar level of 571 mg/dL and a glycated hemoglobin level of 14.6%. The patient underwent emergency percutaneous abscess drainage, and intensive care was subsequently initiated. Klebsiella pneumoniae was detected in both the abscess cavity and blood cultures. The drain was removed 3 weeks later, and the patient was discharged.

CONCLUSION
Emphysematous liver abscesses are often observed in patients with poorly controlled diabetes, and the fatality rate is extremely high. Fever and malaise occasionally mask life-threatening infections in diabetic patients, necessitating careful examination.

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