Gram stain of abscess fluid showed heavy neutrophils and gram-negative rods. Magnification 1000x.Ī large liver abscess was drained by using CT scans as a guide samples of the liver abscess were submitted for aerobic and anaerobic culture. Note the gram-negative staining characteristics and presence of subterminal endospores. Gram strain of Clostridium hathewayi from growth on solid agar media. Two sets of BacT/Alert FAN (bioMerieux Inc., Durham, NC) aerobic and anaerobic blood cultures were drawn, after which the patient received empiric intravenous piperacillin-tazobactam therapy.įigure 1. Acute cholecystitis and hepatic abscess were diagnosed. Abdominal ultrasound and computed tomographic (CT) scans showed gallbladder wall thickening and inflammation, multiple gallstones, and a single large fluid collection in the right lobe of the liver, with multiple adjacent smaller satellite fluid collections. Laboratory testing showed a peripheral leukocytosis with a left shift. Other findings were unremarkable except for mild right upper quadrant abdominal discomfort with deep palpation. Upon physical examination, the patient appeared mildly ill and had a temperature of 39.8☌, along with sinus tachycardia. His medical history, family history, and examination were unremarkable. The patient did not have a history of recent travel outside of Canada and was not taking any medications. The patient did not use alcohol heavily, use intravenous drugs, or engage in high-risk sexual activity. He did not report nausea, vomiting, diarrhea, or jaundice. The patient sought treatment at the hospital for a 2-week history of intermittent fever and chills that were associated with sharp, nonradiating, right upper quadrant abdominal pain. Our patient was a 27-year-old, previously healthy Chinese man who immigrated to Canada 10 years previously. Hatheway in recognition of his contributions to the C. hathewayi is a newly described species that was first reported by Steer et al. The most commonly encountered, clinically important clostridia include Clostridium perfringens, C. Such conditions are usually endogenous (e.g., brain abscess, pneumonia, intrabdominal abscess, cholecystitis, bacteremia) and arise from the host’s own microflora other illnesses may be exogenous (e.g., food poisoning, pseudomembranous colitis, tetanus, botulism, myonecrosis) ( 1). may be involved in a wide variety of human infections or illnesses. More than 150 species have been described to date, but most are believed to be harmless saprophytes ( 1). Clostridium strains are widely distributed in the environment and form part of the normal colonic microflora of humans and many animals ( 1, 2). The genus Clostridium is a phylogenetically heterogeneous group of anaerobic, endospore-forming, rod-shaped bacteria they are usually gram positive, but some species may stain gram variable or gram negative ( 1, 2).
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