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Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess

Liver abscess (LA) is a serious infectious disease, but is relatively rare in the paediatric population, especially in developed countries. Mostly, hepatic abscesses are pyogenic, caused by Staphylococcus aureus, while in extremely rare cases can be caused by parasites, such as Ascaris lumbricoides....

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Autores principales: Ieşanu, Mara-Ioana, Cliveti, Ramona, Anghel, Mălina, Stoicescu, Mihai-Mirel, Boboc, Cătălin, Ioan, Andreea, Galoş, Felicia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705542/
https://www.ncbi.nlm.nih.gov/pubmed/34946267
http://dx.doi.org/10.3390/medicina57121322
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author Ieşanu, Mara-Ioana
Cliveti, Ramona
Anghel, Mălina
Stoicescu, Mihai-Mirel
Boboc, Cătălin
Ioan, Andreea
Galoş, Felicia
author_facet Ieşanu, Mara-Ioana
Cliveti, Ramona
Anghel, Mălina
Stoicescu, Mihai-Mirel
Boboc, Cătălin
Ioan, Andreea
Galoş, Felicia
author_sort Ieşanu, Mara-Ioana
collection PubMed
description Liver abscess (LA) is a serious infectious disease, but is relatively rare in the paediatric population, especially in developed countries. Mostly, hepatic abscesses are pyogenic, caused by Staphylococcus aureus, while in extremely rare cases can be caused by parasites, such as Ascaris lumbricoides. Antimicrobial therapy and percutaneous drainage are the treatments of choice, lowering the mortality caused by this infection. We report a case of a 3-year-old girl admitted to the hospital for abdominal pain and a low-grade fever, with abdominal ultrasonography revealing a hepatic lesion. Initial laboratory tests showed moderate anaemia, thrombocytosis, eosinophilia, high inflammatory markers, and normal liver function. A computed tomography scan revealed two liver abscesses located subdiaphragmatically, and a high immunoglobulin E (IgE) value (22,300 U/mL). After excluding other possible etiologies, the patient was tested for parasitic infections. IgE for Ascaris lumbricoides came slightly higher. In addition to empirical antibiotic treatment, the patient received albendazole and made an uneventful recovery, with the full remission of the abscesses and without the need for drainage. In certain cases, parasites such as Ascaris lumbricoides are capable of inducing a T helper 2 (Th2) dominated immune response, predisposing the host to eosinophilia, hyperIgE, and increased susceptibility to bacterial infections. Early diagnosis and treatment in these cases may lead to less invasive therapy options in order to obtain a full recovery. To the best of our knowledge, this is the only reported case in the literature of a paediatric patient with parasite-induced liver abscesses, with extremely high IgE values, minimal symptomatology, that made a fast, full recovery without the need of drainage.
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spelling pubmed-87055422021-12-25 Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess Ieşanu, Mara-Ioana Cliveti, Ramona Anghel, Mălina Stoicescu, Mihai-Mirel Boboc, Cătălin Ioan, Andreea Galoş, Felicia Medicina (Kaunas) Case Report Liver abscess (LA) is a serious infectious disease, but is relatively rare in the paediatric population, especially in developed countries. Mostly, hepatic abscesses are pyogenic, caused by Staphylococcus aureus, while in extremely rare cases can be caused by parasites, such as Ascaris lumbricoides. Antimicrobial therapy and percutaneous drainage are the treatments of choice, lowering the mortality caused by this infection. We report a case of a 3-year-old girl admitted to the hospital for abdominal pain and a low-grade fever, with abdominal ultrasonography revealing a hepatic lesion. Initial laboratory tests showed moderate anaemia, thrombocytosis, eosinophilia, high inflammatory markers, and normal liver function. A computed tomography scan revealed two liver abscesses located subdiaphragmatically, and a high immunoglobulin E (IgE) value (22,300 U/mL). After excluding other possible etiologies, the patient was tested for parasitic infections. IgE for Ascaris lumbricoides came slightly higher. In addition to empirical antibiotic treatment, the patient received albendazole and made an uneventful recovery, with the full remission of the abscesses and without the need for drainage. In certain cases, parasites such as Ascaris lumbricoides are capable of inducing a T helper 2 (Th2) dominated immune response, predisposing the host to eosinophilia, hyperIgE, and increased susceptibility to bacterial infections. Early diagnosis and treatment in these cases may lead to less invasive therapy options in order to obtain a full recovery. To the best of our knowledge, this is the only reported case in the literature of a paediatric patient with parasite-induced liver abscesses, with extremely high IgE values, minimal symptomatology, that made a fast, full recovery without the need of drainage. MDPI 2021-12-02 /pmc/articles/PMC8705542/ /pubmed/34946267 http://dx.doi.org/10.3390/medicina57121322 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Ieşanu, Mara-Ioana
Cliveti, Ramona
Anghel, Mălina
Stoicescu, Mihai-Mirel
Boboc, Cătălin
Ioan, Andreea
Galoş, Felicia
Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess
title Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess
title_full Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess
title_fullStr Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess
title_full_unstemmed Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess
title_short Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess
title_sort parasite-induced th2 polarization—an unusual cause of paediatric hepatic abscess
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705542/
https://www.ncbi.nlm.nih.gov/pubmed/34946267
http://dx.doi.org/10.3390/medicina57121322
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