A Case of Infected Liver Cyst Treated with Percutaneous Transhepatic Liver Cyst Aspiration

Abstract

A 73-year-old man consulted a local clinic complaining of a high fever over 38°C and was treated with antibiotic therapy several times. However, the high fever continued and his serum C-reactive protein concentration rose to 14.8mg/dL. A liver abscess was suspected based on abdominal enhanced CT findings, and he was referred to our hospital. Tenderness and percussion tenderness were noted in the precordial space. Abdominal CT in the clinic revealed an enhanced thick-walled low-density area in the lateral segment of the liver, and abdominal ultrasonography demonstrated a 75mm anechoic lesion with hypoechoic sediment. The lesion was therefore diagnosed as an infected liver cyst, and percutaneous transhepatic liver cyst aspiration was performed under ultrasonic guidance. Milky sticky fluid was obtained from the cyst. Gram's staining for the drainage fluid showed neutrophilic infiltration and no bacteria. The patient's body temperature returned to normal the following day. Inflammation-related laboratory data decreased, and ultrasonography showed a reduction of the cyst. He was discharged on the sixth hospital day. No bacterium was cultured from the drainage fluid. Percutaneous transhepatic drainage using a catheter is generally performed for the infected liver cyst. In our patient, however, percutaneous transhepatic liver cyst aspiration, which was less invasive, was effective.