Hepatic abscess presenting as severe fatigue and anemia
V. Nguyen and J. P. Richardson
Group Health Association, Tysons Corner Medical Center, Vienna, Va.
We describe a 54-year-old woman who had severe anemia as the initial
presentation of a pyogenic hepatic abscess. She was afebrile and denied any
gastrointestinal symptoms other than anorexia. We discovered her hepatic
abscess when we evaluated her for an occult malignancy as the cause of her
anemia. She was treated with percutaneous drainage of her abscess and
parenteral antibiotic therapy. We searched MEDLINE, a computerized
database, to find other patients whose hepatic abscesses presented as
anemia. Although mild anemia is a common accompaniment of pyogenic hepatic
abscesses, we found no reports of patients who presented with fatigue and
anemia without any of the more common symptoms of hepatic abscess, such as
fever, right upper quadrant pain, malaise, or nausea. We conclude that
anemia without fever or abdominal symptoms is a rare presentation of
pyogenic hepatic abscess.
