PMID- 34946267
OWN - NLM
STAT- MEDLINE
DCOM- 20211227
LR  - 20211229
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 57
IP  - 12
DP  - 2021 Dec 2
TI  - Parasite-Induced Th2 Polarization-An Unusual Cause of Paediatric Hepatic Abscess.
LID - 10.3390/medicina57121322 [doi]
LID - 1322
AB  - 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.
FAU - Iesanu, Mara-Ioana
AU  - Iesanu MI
AUID- ORCID: 0000-0001-9766-1558
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
FAU - Cliveti, Ramona
AU  - Cliveti R
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
FAU - Anghel, Malina
AU  - Anghel M
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
FAU - Stoicescu, Mihai-Mirel
AU  - Stoicescu MM
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
AD  - Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 
      020021 Bucharest, Romania.
FAU - Boboc, Catalin
AU  - Boboc C
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
FAU - Ioan, Andreea
AU  - Ioan A
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
FAU - Galos, Felicia
AU  - Galos F
AD  - Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania.
AD  - Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 
      020021 Bucharest, Romania.
LA  - eng
PT  - Case Reports
DEP - 20211202
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Animals
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Drainage
MH  - Female
MH  - Humans
MH  - *Liver Abscess/diagnostic imaging/drug therapy
MH  - *Parasites
MH  - *Staphylococcal Infections/drug therapy
PMC - PMC8705542
OTO - NOTNLM
OT  - Th2 response
OT  - hepatic abscess
OT  - immune system
OT  - parasites
COIS- The authors declare no conflict of interest.
EDAT- 2021/12/25 06:00
MHDA- 2021/12/28 06:00
PMCR- 2021/12/02
CRDT- 2021/12/24 01:11
PHST- 2021/10/29 00:00 [received]
PHST- 2021/11/26 00:00 [revised]
PHST- 2021/11/30 00:00 [accepted]
PHST- 2021/12/24 01:11 [entrez]
PHST- 2021/12/25 06:00 [pubmed]
PHST- 2021/12/28 06:00 [medline]
PHST- 2021/12/02 00:00 [pmc-release]
AID - medicina57121322 [pii]
AID - medicina-57-01322 [pii]
AID - 10.3390/medicina57121322 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2021 Dec 2;57(12):1322. doi: 10.3390/medicina57121322.