Liver abscess due to Eikenella corrodens, Prevotella meloninogenica, and Lactobacillus spp. Following pancreatoduodenectomy: Case report and review of the literature

Background: Liver abscess may be a complication after pancreatectomy. Eikenella corrodens is a rare pathogen associated with sepsis and endocarditis among other infections. Methods: We report on a patient who developed a polymicrobial liver abscess with three unusual pathogens three months following pylorus preserving pancreatoduodenectomy and adjuvant chemotherapy for pancreatic adenocarcinoma. A review of the literature with regard to liver abscesses caused by the rare pathogens was performed. Results: The eight cm pyogenic liver abscess, which grew Eikenella corrodens, Prevotella melaninogenica, and Lactobacillus spp., was successfully treated with percutaneous drainage and antibiotic therapy using piperacillin=tazobactam followed by ertapenem. Literature review for previously reported cases of liver abscesses due to these organisms revealed that most were percutaneously drained and had good outcome. Eikenella corrodens (n=10) and Prevotella (n=8) liver abscesses were typically polymicrobial, whereas Lactobacillus (n=6) liver abscesses were more commonly monomicrobial. Conclusions: Uncommon organisms such as Eikenella corrodens causing uncommon infections such as liver abscesses must be considered after pancreatic resection with adjuvant chemotherapy. Following species diagnosis, favorable outcome can be achieved.