Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Liver abscess presenting with dyspnea and right-side neck pain that can be overlooked in the emergency department: a case report
1Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, 14584 Bucheon, Republic of Korea
DOI: 10.22514/sv.2021.213 Vol.19,Issue 1,January 2023 pp.157-159
Submitted: 08 July 2021 Accepted: 10 August 2021
Published: 08 January 2023
*Corresponding Author(s): Young Soon Cho E-mail: emer0717@gmail.com
*Corresponding Author(s): Sangsoo Han E-mail: brayden0819@daum.net
† These authors contributed equally.
Liver abscess is a potentially fatal mass associated with liver injury and disease with a mortality rate of 12% if treatment is delayed. Patients usually complain of fever or upper abdominal pain; however, atypical symptoms, such as right shoulder pain, may also appear. We report a case of liver abscess presenting as dyspnea and right-side neck pain without any other symptoms. A 78-year-old man visited the hospital complaining of right-side neck pain, which had persisted for 10 days, and dyspnea that developed over time. The neck pain and dyspnea were aggravated with changes in posture. Arterial blood gas results (pH 7.47, PO2 76 mmHg, PCO2 33 mmHg, SpO2 98%) and chest and neck X-rays were normal, but white blood cell and C-reactive protein levels were higher than normal. A contrast-enhanced computed tomography scan of the chest was performed to differentiate the unexplained dyspnea and neck pain, and the liver abscess, which was diagnosed accidentally. Clinicians should consider liver abscess as a differential diagnosis in patients with dyspnea or neck pain when there is an increase in inflammatory marker, but it is difficult to explain the cause.
Liver abscess; Phrenic nerve; Dyspnea; Neck pain; Referred pain
Sangun Nah,Young Soon Cho,Sangsoo Han. Liver abscess presenting with dyspnea and right-side neck pain that can be overlooked in the emergency department: a case report. Signa Vitae. 2023. 19(1);157-159.
[1] Kavaliauskaitė A, Buginytė R. Pyogenic liver abscess: literature review. Pathogenesis. 2021; 2: 8.
[2] Albenmousa A, Sanai FM, Singhal A, Babatin MA, AlZanbagi AA, Al-Otaibi MM, et al. Liver abscess presentation and management in Saudi Arabia and the United Kingdom. Annals of Saudi Medicine. 2011; 31: 528–532.
[3] Lee C-C, Chang W-K. Liver abscess presenting with persistent hiccups and right shoulder pain. QJM: An International Journal of Medicine. 2020; 113: 203–204
[4] Dupont G, Tubbs RS. The Phrenic Nerve. Surgical Anatomy of the Cervical Plexus and its Branches (pp. 31–41). Elsevier: Amsterdam, The Netherlands. 2022.
[5] Park SH, Lee PB, Seo MS, Lim YH, Oh YS. Referred Shoulder Pain due to Liver Abscess -a case report. The Korean Journal of Pain. 2005; 18: 267–270.
[6] Williams R, Larson NS, Pinsker JE. Occult pyogenic liver abscess in an adolescent with type 2 diabetes. Endocrine. 2014; 45: 335–336.
[7] Subramaniyam V, Saito A, Tokushige K. Liver abscess due to Fusobac-terium species detected on ultrasonography: a case report. Journal of Medical Ultrasonics. 2018; 45: 623–627.
[8] Kokatnur L, Rudrappa M. Diaphragmatic Palsy. Diseases. 2018; 6: 16.
[9] Bektas F, Soyuncu S. Diaphragmatic irritation caused by nail-gun: an unusual cause of bradycardia/Civi tabancasina bagli diyafram irritasyonu: bradikardinin nadir bir nedeni. Academic Emergency Medicine. 2012; 11: 243–245.
[10] Blair RW, Weber RN, Foreman RD. Responses of thoracic spinothalamic neurons to intracardiac injection of bradykinin in the monkey. Circulation Research. 1982; 51: 83–94.
[11] Hobbs SF, Chandler MJ, Bolser DC, Foreman RD. Segmental organiza-tion of visceral and somatic input onto C3-T6 spinothalamic tract cells of the monkey. Journal of Neurophysiology. 1992; 68: 1575–1588.
[12] Abdul-Hamid A, Bailey S. Klebsiella pneumoniae liver abscess and endophthalmitis. BMJ Case Reports. 2013; 2013: bcr2013008690.
[13] Hsieh M, Lu T, Ma MH, Wang H, Chen S. Unrecognized cervical spinal epidural abscess associated with metastatic Klebsiella pneumoniae bacteremia and liver abscess in nondiabetic patients. Diagnostic Micro-biology and Infectious Disease. 2009; 65: 65–68.
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