16歲男性罹患無菌性肝膿瘍及無已存在疾病的病例報告

Sterile Liver Abscess with No Predisposing Factors in a 16-year-old Boy

16歲男童，有高燒，畏寒及上腹痛，吃不下3天，來就診住院。男童外觀發育良好，無過去病史及家族病史，最近沒有旅遊及感染紀錄，其血液學檢查，C-反應蛋白升高，其餘均正常，生化學檢查，肝功能升高，其餘均正常。理學檢查呈現上腹部壓痛，無其他異常發現。腹部電腦斷層掃描顯示在S2/S3處有膿瘍，內有膈腔，診斷為膿瘍。所抽出來的肝內膿液、血液、尿液、糞便細菌培養均陰性。給予靜脈抗生素2星期，及口服抗生素2星期，病童再追蹤所做檢查均正常。由此病例了解兒童及青少年的肝膿瘍可能找不出病因及培養不出細菌，所以有上述症狀者應提高警覺，早期診斷及治療。

Liver abscess remains an uncommon and serious disease. In children, it often leads to delay in diagnosis. This case report discusses a case of 16-year-old boy with unusual presentation of liver abscess and negative microbiological cultures for any sources of infection. This patient improves with antibiotic treatment alone. This case demonstrates liver abscess can be sterile with variable presentation in pediatric patients. Recognition of variable presentation of liver abscess is vital and important.