Diagnostic and Management of Emphysematous Hepatitis with Emphasis on Biopathology

Author:

Porez Déborah1,Kallel Hatem2,Dobian Succes3,Gerbert-Ferrendier Timotée4,Nacher Mathieu5ORCID,Djossou Félix1,Demar Magalie6ORCID,Amroun Hakim7,Zappa Magaly3,Drak Alsibai Kinan458ORCID

Affiliation:

1. Unité des Maladies Infectieuses Tropicales (UMIT), Cayenne Hospital Centre, F-97306 Cayenne, France

2. Réanimation Polyvalente, Pôle Urgences-Soins Critiques, Cayenne Hospital Centre, F-97306 Cayenne, France

3. Service d’Imagerie Médicale, Cayenne Hospital Centre, F-97306 Cayenne, France

4. Department of Pathology, Cayenne Hospital Centre, F-97306 Cayenne, France

5. Amazin PopHealth, Département de Recherche et d’Innovation en Santé Publique (DRISP), Inserm Centre d’Investigation Clinique (CIC 1424), Cayenne Hospital Centre Andrée Rosemon, F-97300 Cayenne, France

6. Department of Surgery, Cayenne Hospital Centre, F-97306 Cayenne, France

7. Laboratoire Polyvalent, Cayenne Hospital Centre, F-97306 Cayenne, France

8. Centre of Biological Resources (CRB Amazonie), Cayenne Hospital Centre, F-97306 Cayenne, France

Abstract

Emphysematous hepatitis is a rare infectious disease, which corresponds to the presence of gas in the liver, without collection and after exclusion of vascular origin. This entity belongs to the group of emphysematous infections, whose physiopathology seems to be linked to the presence of unbalanced diabetes and to bacterial fermentation, leading to the production of gas within the liver parenchyma. Very few cases of emphysematous hepatitis have been described in the literature, and most of them had a rapidly fatal course. In this manuscript, we report the case of a 59-year-old man with emphysematous hepatitis due to wild-type Klebsiella pneumoniae that was successfully managed by surgery, and we perform a review of the literature to describe the clinical and biopathological aspects of this rare hepatic disease. Our manuscript underlines the need to perform biological and histopathological sampling to better understand the pathophysiology of this rare entity. The causes and mechanisms of emphysematous hepatitis, which seem to be multiple, lead us to believe that it is a syndrome rather than a simple infectious disease.

Publisher

MDPI AG

Subject

Virology,Microbiology (medical),Microbiology

Reference24 articles.

1. Acute fulminant hepatic infection causing fatal «emphysematous hepatitis»: Case report;Blachar;Abdom. Imaging,2002

2. Gas Where It Shouldn’t Be! Imaging Spectrum of Emphysematous Infections in the Abdomen and Pelvis;Nepal;AJR Am. J. Roentgenol.,2021

3. Gas-Forming Liver Abscess versus Emphysematous Hepatitis: A Radiologic Diagnostic Dilemma—A Case Report and Review of the Literature;Ghosn;Case Rep. Hepatol.,2019

4. Fulminant infection with emphysematous changes in the biliary tract and air-filled liver abscesses;Aisa;Abdom. Imaging,2006

5. Answer to case of the month #162. Emphysematous infection of the liver parenchyma;Audet;Can. Assoc. Radiol. J.,2010

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