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Aseptic abscess syndrome

A 43-year-old woman with Crohn’s disease was admitted to the hospital with weight loss and 1 week of fever, abdominal pain and diarrhoea. At presentation, the patient was not on steroids or other immunosuppressive agents. Cross-sectional imaging of the abdomen revealed active colitis and multiple sp...

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Autores principales: Fillman, Hannah, Riquelme, Patricio, Sullivan, Peter D, Mansoor, André Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597475/
https://www.ncbi.nlm.nih.gov/pubmed/33122231
http://dx.doi.org/10.1136/bcr-2020-236437
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author Fillman, Hannah
Riquelme, Patricio
Sullivan, Peter D
Mansoor, André Martin
author_facet Fillman, Hannah
Riquelme, Patricio
Sullivan, Peter D
Mansoor, André Martin
author_sort Fillman, Hannah
collection PubMed
description A 43-year-old woman with Crohn’s disease was admitted to the hospital with weight loss and 1 week of fever, abdominal pain and diarrhoea. At presentation, the patient was not on steroids or other immunosuppressive agents. Cross-sectional imaging of the abdomen revealed active colitis and multiple splenic and hepatic abscesses. All culture data were negative, including aspiration of purulent material from the spleen. Despite weeks of intravenous antibiotics, daily fever and abdominal pain persisted, the intra-abdominal abscesses grew, and she developed pleuritic chest pain and consolidations of the right lung. The patient was ultimately diagnosed with aseptic abscess syndrome, a rare sequelae of inflammatory bowel disease. All antimicrobials were discontinued and she was treated with high-dose intravenous steroids, resulting in rapid clinical improvement. She was transitioned to infliximab and azathioprine as an outpatient and repeat imaging demonstrated complete resolution of the deep abscesses that had involved her spleen, liver and lungs.
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spelling pubmed-75974752020-11-05 Aseptic abscess syndrome Fillman, Hannah Riquelme, Patricio Sullivan, Peter D Mansoor, André Martin BMJ Case Rep Rare Disease A 43-year-old woman with Crohn’s disease was admitted to the hospital with weight loss and 1 week of fever, abdominal pain and diarrhoea. At presentation, the patient was not on steroids or other immunosuppressive agents. Cross-sectional imaging of the abdomen revealed active colitis and multiple splenic and hepatic abscesses. All culture data were negative, including aspiration of purulent material from the spleen. Despite weeks of intravenous antibiotics, daily fever and abdominal pain persisted, the intra-abdominal abscesses grew, and she developed pleuritic chest pain and consolidations of the right lung. The patient was ultimately diagnosed with aseptic abscess syndrome, a rare sequelae of inflammatory bowel disease. All antimicrobials were discontinued and she was treated with high-dose intravenous steroids, resulting in rapid clinical improvement. She was transitioned to infliximab and azathioprine as an outpatient and repeat imaging demonstrated complete resolution of the deep abscesses that had involved her spleen, liver and lungs. BMJ Publishing Group 2020-10-29 /pmc/articles/PMC7597475/ /pubmed/33122231 http://dx.doi.org/10.1136/bcr-2020-236437 Text en © BMJ Publishing Group Limited 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Rare Disease
Fillman, Hannah
Riquelme, Patricio
Sullivan, Peter D
Mansoor, André Martin
Aseptic abscess syndrome
title Aseptic abscess syndrome
title_full Aseptic abscess syndrome
title_fullStr Aseptic abscess syndrome
title_full_unstemmed Aseptic abscess syndrome
title_short Aseptic abscess syndrome
title_sort aseptic abscess syndrome
topic Rare Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597475/
https://www.ncbi.nlm.nih.gov/pubmed/33122231
http://dx.doi.org/10.1136/bcr-2020-236437
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