# Complex Hepatic Abscess in a Child Following Esophageal Procedures: Clinical Insights and Management

## TL;DR

A child developed a rare liver infection after esophageal procedures, highlighting the need for infection prevention in similar cases.

## Contribution

This case report highlights the risk of hepatic abscesses following esophageal interventions in children and suggests the need for prophylactic antibiotics.

## Key findings

- A five-year-old girl developed a complex hepatic abscess after multiple esophageal interventions.
- Bacterial translocation from oral cavity organisms was suspected as the cause of the abscess.
- Antibiotic management and source control were necessary for recovery.

## Abstract

This case report describes a rare occurrence of a hepatic abscess in a five-year-old girl following esophageal interventions due to caustic ingestion. Persistent strictures led to multiple balloon dilations and serial esophageal stents, after which she developed abdominal pain, fever, and anorexia. Imaging revealed a complex hepatic abscess. Cultures identified Eikenella corrodens and Prevotella oralis, organisms typically found in the oral cavity, suggesting bacterial translocation due to mucosal disruption from the esophageal procedures. The patient initially received ceftriaxone and metronidazole, showing improvement, but experienced fever recurrence upon switching to ampicillin/sulbactam, necessitating a return to the original antibiotic regimen. The patient eventually recovered with continued treatment, highlighting the risk of serious infections following esophageal interventions in pediatric patients. This case underscores the importance of considering prophylactic antibiotics to prevent such complications, especially in high-risk pediatric patients undergoing repeated interventions. When infectious complications do occur, both antibiotic management and source control are necessary for definitive treatment. Further research is needed to establish guidelines for prophylactic measures in similar clinical scenarios.