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Abstract: This patient first presented with symptoms of chills and fever, and each fever was accompanied by general shivering and a temperature as high as 39℃. After about 1 week of treatment in an outside hospital, the symptoms had not subsided, so he came to our Infection Department, and was transferred to our department after an abdominal CT examination suggesting a liver abscess, and was given liver abscess puncture and drainage, as well as anti-infective treatment with cefoperazone sodium for injection. The abscess basically disappeared in 10 days after treatment, and the blood picture was basically normal, and the body temperature returned to normal and was discharged.
Basic information】Male, 51 years old
Disease Type】Hepatic abscess, diabetes mellitus
Hospital】Liaocheng People’s Hospital
Date of consultation】November 2021
Treatment plan】Insulin pump + surgical treatment (liver abscess puncture and drainage) + drug treatment (cefoperazone sodium for injection)
Treatment period】10 days of hospitalization
Treatment effect] The liver abscess basically disappeared, the blood picture was basically normal, and the body temperature returned to normal and was discharged from the hospital.
I. Initial consultation
The patient’s initial symptoms were chills and high fever, and each fever was accompanied by shaking of the whole body, and each time the body temperature could reach about 39℃. The patient came to our hospital for further treatment because he had anti-infection treatment at an outside hospital, but the effect was not obvious and he had fever every day. The initial consultation was admitted to the Infection Department, which checked the relevant infection indicators. The blood picture was significantly elevated, and the blood culture suggested Escherichia coli infection. The patient was given an abdominal CT examination, which suggested an abscess of about 5 cm in diameter on the liver. The symptoms were considered to be caused by a liver abscess. Since the patient usually had diabetes and usually had poor blood sugar control, the appearance of liver abscess was also related to diabetes, so he was referred to our department after consultation.
II. Treatment process
After the patient was transferred to our department, we monitored the patient’s blood glucose, which was about 10 mmol/L fasting and 15 mmol/L or even 20 mmol/L after meal, suggesting that the blood glucose control was very poor. A total of 100mL of pus was drained out with foul odor, and the pus cavity was flushed out, while cefoperazone sodium for injection was given as anti-infection treatment. After treatment, the patient’s blood sugar was gradually controlled and stabilized, and the symptoms of fever were gradually controlled, and the body temperature returned to normal.
III. Treatment effect
Since the patient’s puncture and drainage was performed under local anesthesia with ultrasound guidance, the trauma was very small. After the successful puncture, we drained and flushed the pus from the patient’s liver abscess, and the patient’s fever symptoms were improved quickly. After anti-infection treatment with cefoperazone sodium for injection, the patient’s blood picture also quickly dropped to normal. Through the above 10 days of comprehensive treatment, the patient’s general condition recovered and he was discharged from the hospital immediately.
IV. Notes
We are glad that the patient’s symptoms have been improved after treatment, but because this time the patient suffered from liver abscess mainly related to poor blood sugar control, so after discharge from the hospital, we must actively control blood sugar, control blood sugar, and pay attention to the following matters.
1. diet: a scientific diabetic diet should be carried out, and if the patient does not quite understand the diabetic diet, he can consult a diabetic clinic for dietary guidance.
2, medication: to regular application of blood glucose control drugs, this situation is recommended to consult the diabetes clinic for drug adjustment. At the same time, the patient should come to the hospital for a review after 1 week after discharge and have an abdominal CT examination to observe the disappearance of liver abscess.
V. Personal insight
Through this case, we can summarize that this patient’s liver abscess was caused by poor blood sugar control, but fortunately, after active blood sugar control and liver abscess puncture and drainage, the condition was controlled. Nowadays, the incidence of diabetes is getting higher and higher, and many diabetic patients have liver abscess due to poor blood sugar control, so the incidence of liver abscess is getting higher and higher. The treatment is mainly early anti-infection treatment, and if the liver abscess liquefies more obviously, puncture and drainage can be used. If the liver abscess is more stubborn, it may also need to be removed surgically. In conclusion, it is important for diabetic patients to actively control their blood sugar, and if the blood sugar is not well controlled it is recommended to consult a diabetes clinic for treatment.