Corticosteroid therapy for liver abscess in chronic granulomatous disease

Abstract

Liver abscesses in chronic granulomatous disease (CGD) are typically difficult to treat and often require surgery. We describe 9 X-linked CGD patients with staphylococcal liver abscesses refractory to conventional therapy successfully treated with corticosteroids and antibiotics. Corticosteroids may have a role in treatment of Staphylococcus aureus liver abscesses in CGD.

Figure 1.

Computed tomography (CT) and magnetic resonance imaging (MRI) on patient 2. Axial (A) and coronal (B) contrast-enhanced CT images demonstrate a multiseptated abscess within the right lobe of liver measuring 8 cm in maximal craniocaudal dimension (white arrowheads [A]; white arrow [B]). Axial T2 (C) and coronal postgadolinium MRI images (D) with fat saturation obtained 11 months after presentation demonstrate minimal residual T2 signal abnormality (white arrow [C]) and marked reduction in size of the abnormal enhancement within the right lobe of liver (white arrow [D]) now measuring 3.5 cm in diameter.

Figure 2.

Computed tomography (CT) and magnetic resonance imaging (MRI) on patient 9. Axial (A) and coronal (B) contrast-enhanced CT images demonstrate a multiseptated abscess (white arrowheads [A]; white arrow [B]) within the right hepatic lobe measuring 12.4 cm in maximal craniocaudal dimension. Axial T2-weighted (C) and coronal postgadolinium (D) MRI images with fat saturation obtained 4 months after initial presentation demonstrate minimal residual T2 signal abnormality (white arrow [C]) and marked reduction in the abnormal enhancement within the right lobe of liver (white arrow [D]), now measuring 4.8 cm in aggregate diameter.