Presentation
Raised inflammatory markers in an immunosuppressed patient. Previous medical history of lung infections, peri-orbital abscess, and perianal abscess.
Patient Data
There are multiple circumscribed hypodense liver lesions with likely fluid attenuation highly suggestive of hepatic abscesses. Also, the spleen has smaller ill-defined hypodense lesions that are similarly concerning for abscesses. The remainder of the hollow and solid abdominal viscera are unremarkable.
US confirmed the multiple hepatosplenic lesions in keeping with abscesses.
Case Discussion
Chronic granulomatous disease is a rare genetic immunodeficiency related to neutrophil function impairment. In a simple way to understand it, these cells are unable to kill certain microorganisms, which survive within the phagosome leading to chronic inflammatory cell reactions and therefore granuloma formation. These patients will have recurrent infections affecting different organs, persistent inflammation, and the formation of granulomas.
This young patient has his diagnosis confirmed since his first year of age, since then, multiple hospital admissions for recurrent infections. The larger liver abscess was aspirated and cultured positive for Aspergillus.
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