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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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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. |
format | Online Article Text |
id | pubmed-7597475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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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