On liver damage at generalized form of coxiellosis. Case report

Abstract

Disease case has been analyzed at 59 years old female patient, living in rural area. The disease progressed with long-time and high fever accompanied with liver damage including formation of abscesses. Anamnesis showed that raw milk was consumed. During 1.5 months, high steady fever, weakness, sweating and anorexia were observed, with further moderate pain in a right abdominal wing. The whole period of disease was noted with hepatomegaly, worsening leukocytosis, ESR 60 mm/hr, and moderate hyperenzymenia. SCT findings showed an inhomogene hypoechoic formation in a right hepatic lobe in segment’s projection 7, with sharp margins, dimension 3,0 2,2 cm, with 4 nearby liquor formations up to 1.2 cm in diameter. The percutaneous puncture biopsy, liquor formation aspiration and automatic trepanobiopsy of the tissue pattern of the formation under consideration. Cytological study revealed a non-specific inflammation with pus. Atypical cells not found. Histological findings: biopsy material from liver does contain a fibrous tissue with granulomatous inflammation. Complex detoxicating, metabolic and desensibilizing therapy was performed in combination with Ofloxacin, Meropenem (14 days), and Doxycycline (20 days). Diagnosed coxiellosis was confirmed with ELISA in titer 1:400/ОD 0,587 –ОD/0,726. The patient is fully recovered.