A Case of Pyogenic Liver Abscess Complicated by Hepatobronchial Fistula

Hepatobronchial fistula, an anatomic communication between the liver parenchyma and the bronchial tree, is a rare condition, which usually develops as a complication of amoebiasis, hydatid cysts, and trauma. We report on a case of a pyogenic liver abscess complicated by a hepatobronchial fistula, which responded well to treatment with antibiotics and percutaneous drainage. A 36-year-old male patient presented with a two-week history of dry cough, shortness of breath, right side abdominal pain, and fever. Chest computed tomography scan showed a heterogeneously enhanced abscess measuring approximately 6 cm in the right liver dome. Percutaneous drainage was performed and antibiotics were administered against Group C Streptococcus cultured from the abscess. After nine days of therapy, repositioning of the drainage catheter was performed and the patient coughed suddenly during injection of contrast media, and communication from abscess to bronchus was discovered. While maintaining abscess drainage and antibiotic therapy, the fistula diminished gradually and disappeared completely with resolution of the liver abscess.