Hepatic abscesses associated with umbilical catheterisation in two neonates

We describe two neonates with a liver abscess after umbilical venous catheterisation. The first case was a female neonate, born at 32 weeks of gestation. After persistance of elevated inflammatory parameters, an abscess in the right lobe of the liver was diagnosed. Percutaneous drainage under CT guidance was performed. The aspirated pus grew Staphylococcus epidermidis. Inflammatory parameters normalised after 27 days of antimicrobial therapy (vancomycin, cefotaxim, rifampicin). The second case was in a male neonate, born at 29 weeks of gestation. Percutaneously aspirated pus from the liver abscess was cultured and remained sterile. The patient received antimicrobial therapy (vancomycin, cefotaxim, amikacin) for 26 days and was cured with conservative treatment. Conclusion: hepatic abscess should be considered in any infant with an umbilical catheter-associated sepsis and persistent inflammatory response in spite of adequate antimicrobial therapy, especially when signs of abdominal infection are present.