Liver abscess and bacteremia caused by Streptococcus constellatus with suspected ileocecal valve lesion as the entry point

TL;DR

A 68-year-old man developed a rare liver abscess caused by Streptococcus constellatus, with an ileocecal valve lesion suspected as the infection source.

Contribution

Highlights the importance of colonoscopy in identifying infection sources in cryptogenic liver abscesses caused by S. constellatus.

Findings

S. constellatus can cause pyogenic liver abscess and bacteremia.

An inflammatory lesion at the ileocecal valve may serve as an entry point for the infection.

Colonoscopy is recommended for evaluating gastrointestinal sources in cryptogenic PLA cases.

Abstract

Pyogenic liver abscess (PLA) is a rare but potentially life-threatening condition. Streptococcus constellatus, part of the Streptococcus anginosus group, is an uncommon causative agent of PLA, though its incidence has been increasingly reported. We present the case of a 68-year-old man with a history of hypertension, type 2 diabetes, and dyslipidemia, who was admitted after a traffic accident. Medical evaluation revealed bacteremia and liver abscesses caused by S. constellatus, and the patient was treated successfully with drainage and antibiotics. While the patient denied gastrointestinal symptoms, a colonoscopy was performed to investigate a possible portal of entry for the organism, which revealed an inflammatory lesion at the ileocecal valve. This case underscores the importance of colonoscopy in identifying potential sources of infection in cryptogenic PLA and highlights the need for thorough evaluation of gastrointestinal lesions in patients with S. constellatus bacteremia. The patient's loss of consciousness during the traffic accident was attributed to sepsis, reinforcing the critical role of comprehensive internal investigations in trauma patients with unexplained symptoms.

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