{"id":2422,"date":"2023-01-24T13:46:53","date_gmt":"2023-01-24T12:46:53","guid":{"rendered":"https:\/\/angh.net\/abstracts\/quand-un-abces-hepatique-en-cache-un-autre\/"},"modified":"2023-01-24T13:46:53","modified_gmt":"2023-01-24T12:46:53","slug":"quand-un-abces-hepatique-en-cache-un-autre","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/quand-un-abces-hepatique-en-cache-un-autre\/","title":{"rendered":"Quand un abc\u00e8s h\u00e9patique en cache un autre"},"content":{"rendered":"<p><strong>2022<\/strong><\/p>\n<p><em>Cl\u00e9ment DUPRE, Agathe BOUNHIOL, Christelle NGUEMO, Julia ROUX, C\u00e9line SOMSOUK, Anne-Laure DESGABRIEL, Dany RIZK, Pauline CARAUX-PAZ, Armand GARIOUD.<\/em><\/p>\n<p><strong>H\u00e9patologie <\/strong>&#8211; \u00a02022-05-06 &#8211;\u00a0CC &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Madame Ourdia A., une patiente de 80 ans est adress\u00e9e aux Urgences m\u00e9dicales le 22\/12\/2021 pour l\u2019exploration d\u2019une douleur basi-thoracique et lombaire droite avec notion de fi\u00e8vre \u2013 non objectiv\u00e9e \u2013 depuis 5 jours. A l\u2019examen clinique, le principal signe associ\u00e9 est un \u0153il droit rouge et douloureux avec baisse d\u2019acuit\u00e9 visuelle depuis 3 jours. Elle a pour seul ant\u00e9c\u00e9dent une chol\u00e9cystectomie et ne prend aucun traitement habituel. Le bilan biologique initial objective un syndrome inflammatoire avec des leucocytes \u00e0 23,9 G\/l, des polynucl\u00e9aires neutrophiles \u00e0 20,3 G\/l et une CRP \u00e0 215 mg\/l. Le bilan h\u00e9patique est l\u00e9g\u00e8rement perturb\u00e9 avec une cytolyse et une cholestase inf\u00e9rieures \u00e0 2 fois la normale. La bilirubin\u00e9mie est normale. La bandelette urinaire objective une croix de prot\u00e9ines et de nitrites sans leucocytes. La patiente est vue par l\u2019ophtalmologue qui conclut \u00e0 une uv\u00e9ite ant\u00e9rieure aigu\u00eb ; il pr\u00e9conise un traitement par injections sous conjonctivales de dexam\u00e9thasone. Un scanner thoraco-abdomino-pelvien inject\u00e9 est r\u00e9alis\u00e9 \u00e0 la recherche d\u2019un foyer infectieux profond. Il met en \u00e9vidence une formation pseudokystique du foie gauche multi-locul\u00e9e dont l&rsquo;aspect est en faveur d&rsquo;un volumineux abc\u00e8s h\u00e9patique de 10 cm de grand axe (cf photo). Il n\u2019y a pas de foyer pulmonaire ou d\u2019\u00e9panchement pleural associ\u00e9. Une antibioth\u00e9rapie probabiliste par m\u00e9tronidazole et c\u00e9fotaxime est d\u00e9but\u00e9e apr\u00e8s la r\u00e9alisation d\u2019un ECBU \u2013 n\u00e9gatif au direct \u2013 et la patiente est transf\u00e9r\u00e9e en h\u00e9pato-gastro-ent\u00e9rologie le 23\/12 pour la suite de sa prise en charge. Le 24\/12, la patiente pr\u00e9sente une aggravation des sympt\u00f4mes et de l\u2019aspect oculaire avec un oed\u00e8me palp\u00e9bral emp\u00eachant l&rsquo;ouverture de l&rsquo;\u0153il droit. Une IRM est r\u00e9alis\u00e9e. Celle-ci \u00e9voque un aspect d\u2019endophtalmie de l\u2019\u0153il droit (cf photo). Quelles sont vos hypoth\u00e8ses diagnostiques et votre prise en charge devant cette association inhabituelle d\u2019un abc\u00e8s h\u00e9patique \u00e0 une endophtalmie ?<br \/>\nLa suite du cas clinique et l\u2019\u00e9volution de la patiente vous seront pr\u00e9sent\u00e9es lors du Congr\u00e8s \u00e0 Aix-en-Provence.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2022 Cl\u00e9ment DUPRE, Agathe BOUNHIOL, Christelle NGUEMO, Julia ROUX, C\u00e9line SOMSOUK, Anne-Laure DESGABRIEL, Dany RIZK, Pauline CARAUX-PAZ, Armand GARIOUD. H\u00e9patologie &#8211; \u00a02022-05-06 &#8211;\u00a0CC &#8211; ________________________________ Madame Ourdia A., une patiente de 80 ans est adress\u00e9e aux Urgences m\u00e9dicales le 22\/12\/2021 pour l\u2019exploration d\u2019une douleur basi-thoracique et lombaire droite avec notion de fi\u00e8vre \u2013 non objectiv\u00e9e [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[35],"class_list":["post-2422","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-35"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Quand un abc\u00e8s h\u00e9patique en cache un autre - 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