Background: Hepatobronchial fistula is infrequent and secondary to pyogenic abscess caused by Streptococcus intermedius. This agent causes infections such as hepatic abscesses, endocarditis, bacteremia, and others. The treatment includes drainage, antibiotic management, and surgical intervention in some cases.
Case Presentation: We describe a case of a 50-year-old male with a pyogenic liver abscess complicated by hepatobronchial fistula, admitted to the Internal Medicine Department with fever, long-lasting chills, and weight loss. The diagnostic approach revealed a pyogenic abscess secondary to S. intermedius. After percutaneous drainage, the patient presented purulent expectoration. A cavitogram revealed a hepatobronchial fistula. Treatment with antibiotics and closure of the defect was satisfactory.
Conclusion: This is a case of a hepatic abscess due to S. intermedius complicated with hepatobronchial fistula, a rare clinical entity; the opportune hybrid approach (surgical plus interventional and radiological) reduces the risk of a major thoracoabdominal operation, which influenced the good prognosis of our patient.
Key words: Hepatobronchial fistula, hepatic abscess, Streptococcus intermedius, fever, cavitogram, case report.
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