Pyogenic Hepatic Abscess as a Complication of Appendicitis: A Case Report.

Pyogenic liver abscess is a rare and under-recognized complication of gangrenous or perforated appendicitis in children. Management typically requires a combination of antibiotic therapy and abscess drainage. Although uncommon in the pediatric population, pyogenic liver abscess is more frequently observed in the elderly people. With an aging population, it is increasingly important for young physicians to recognize its clinical presentation and treatment strategies. This report describes an 11-year-old boy admitted with fever, impaired consciousness, nausea, and vomiting-initially raising concern for meningitis. A CT scan revealed a hepatic abscess and findings consistent with acute appendicitis. Following multidisciplinary consultation, the patient underwent percutaneous drainage of the liver abscess and an appendectomy. His postoperative course was uneventful, and he was discharged with a liver drain in place. Given the limited reliability of history and physical examination in pediatric patients with septic shock-especially in emergency settings-clinicians must maintain a broad differential diagnosis.