LEBERABSZESSE DURCH YERSINIA ENTEROCOLITICA

: A 41-year-old man with type II diabetes for the past five years had for three weeks been suffering from high fever (up to 40 degrees), feeling of pressure in the upper abdomen, loss of weight, lack of appetite and increasing weakness. Ultrasound examination as an out-patient was suspicious of diffuse liver metastases from an unknown primary tumour. Ultrasonography and computed tomography after hospitalization suggested multiple liver abscesses. Fine-needle biopsy grew Yersinia enterocolitica. In addition, there was evidence of an asymptomatic intestinal Yersinia infection without septicaemia. After intravenous treatment with three times daily 5 g mezlocillin and three times daily 80 mg tobramycin the fever at first subsided, but the liver abscesses remained unchanged. When fever recurred a week later, cefotaxim, three times daily 2 g, was started. This led to complete regression of the abscesses within three weeks, and the patient has been free of symptoms since.