Case Report

Candida glabrata Liver Abscess and Fungemia Complicating Severe Calculus Cholecystitis in an Immunocompetent Nondiabetic Host

Authors: Raquel Lima, MD, Wael Shams, MD, Sumit Kalra, MD, Thomas Borthwick, MD

Abstract

A 64-year-old lady presented to us with excruciating upper abdominal pain and nausea. Her initial labs, ultrasound of the gallbladder and computed tomography (CT) scan of the abdomen revealed acute pancreatitis and cholecystitis. She also had a complex cystic mass in the left lobe of the liver. She underwent a sequence of interventions including percutaneous cholecystostomy, endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, cholecystectomy, CT-guided drainage of the abscess and finally a wedge resection of the liver with definite resolution of the abscess. Blood, bile, and, liver aspirate were cultured and grew Candida glabrata. Pathological analysis of the gallbladder also supported this diagnosis. From the beginning, the patient was given micafungin as well as broad spectrum antibiotics. She responded well to treatment with micafungin with complete resolution and no recurrence of symptoms.

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