Potential Pyogenic Liver Abscess Case Report in Elderly Female Post COVID-19 Vaccination
An 84-year-old female presented with fever, SOB, fatigue, and diarrhea after receiving a COVID-19 vaccine. Despite initial improvement with antibiotics, she developed liver abscess, highlighting the complexity of diagnosing post-vaccination symptoms. Clinicians should remain vigilant and consider all diagnostic possibilities beyond attributing symptoms solely to the vaccine. Vaccine confidence and adherence to safety measures remain crucial in combating COVID-19.
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COVID VACCINE CANNOT BE BLAMED ALWAYS!!!! A CASE REPORT FROM DR LEKSHMY S PILLAI DEPT OF GASTROENTEROLOGY
CASE PRESENTATION CLINICAL EXAMINATION 84 YEAR OLD FEMALE TEMPERATURE -39.8 *C, HR-100 /MIN, BP-110/70MMHG . CONSCIOUS ,ALERT AND ORIENTED AND COPERATIVE . H/O FEVER , SOB , FATIGUE AND DIARRHOEA -10 DAYS PMH- DYSLIPIDEMIA ON DIET CONTROL CARDIAC , PULMONARY AND ABDOMINAL EXAMINATION - WITH IN NORMAL LIMITS NO H/O RECENT TRAVEL LABS LEUCOCYTOSIS (14,000) WITH NEUTROPHILIA . CRP -338 NO H/O CONTACT WITH ANY SICK PERSON CHEST XRAY NORMAL NOTICED THIS SYMPTOMS AFTER ONE WEEK OF COVID VACCINATION
CLINICAL PROGRESSION DISCUSSED WITH MICROBIOLOGTY TEAM AND STARTED ON DUAL ANTIBIOTICS. ADMITTED THE PATIENT IN THE WARD AS A CASE OF FEVER OF UNKNOWN ORGIN AND STARTED ON EMPIRICAL ANTIBIOTICS . ENTAMEOBA ,HYDATID SCREEN & MALIGNANCY SCREEN NEGATIVE. PATIENT SHOWED MARVELLOUS IMPROVEMENT AND SUBSEQUENT CT SHOWED REDUCTION IN THE ABCESS SIZE. STARTED TO INVESTIGATE MORE AS THE PATIENT REMAINED FEBRILE ,NAUSEATED & SICK DESPITE IV ANTIBIOTICS FOR 48 HOURS LFT FOUND TO BE SIGNIFICANTLY RAISED WHICH LEAD TO ULTRASOUND OF ABDOMEN AND A CT ABDOMEN REVEALED A 10 X 5.8X 5.7 CM LESION IN THE RIGHT LOBE OF LIVER SWITCHED TO ORAL ANTIBIOTICS FOR 6 WEEK S AND DISCHARGED HOME HYPODENSE LESION WITH INTERNAL SEPTA AND IRREGULAR MARGINS
CLINICAL DISCUSSION PYOGENIC LIVER ABSCESS (PLA) IS A CONDITION OF HIGH MORTALITY AND MORBIDITY . PLA HAS LOW PREVALENCE IN UK BUT IT CAN STILL POSE A DIAGNOSTIC CHALLENGE FOR FRONT LINE PHYSICIANS . CLINICAL PRESENTATION CAN VARY AND WILL NOT ALWAYS PRESENT WITH FEVER , JAUNDICE AND RIGHT UPPER QUADRANT ABDOMINAL PAIN . COVID VACCINE BEING THE NEW PLAYER IN THE SCENE, ITS VERY COMMON TO ATTRIBUTE THE GENERAL SYMPTOMS OF FEVER AND MALAISE AS AN AEFI ESPECIALLY WHEN WE DON T HAVE A FIRST HAND PROVISIONAL DIAGNOSIS
PEARLS OF PRACTICE CLINICIANS SHOULD HAVE AN OPEN EYE TO EXPLORE ALL DIAGNOSTIC POSSIBILITIES RATHER THAN FOCUSSING ON THE COMMON RED HERRING THESE DAYS THE COVID VACCINE. AS PHYSICIANS WE SHOULDN T FORGET THAT VACCINE CONFIDENCE STARTS WITH US GETTING THE COVID VACCINE AND MASKING GIVES YOU AN ADDED LAYER OF PROTECTION AGAINST COVID19 AND COULD ALSO PROTECT YOUR PATIENTS AND YOUR COLLEAGUES . THANK YOU
