Pyogenic liver abscess caused by pseudomonas aeruginosa: A rare case diagnosed in the microbiology department of Avicenne Military Hospital, Marrakech

Pyogenic liver abscesses are severe infectious diseases associated with significant morbidity and mortality. Enterobacteria remain the most common causative microorganisms, whereas Pseudomonas aeruginosa is rarely involved, particularly in community-acquired infections. We report a rare case of pyogenic liver abscess caused by Pseudomonas aeruginosa, diagnosed in the Microbiology Department of Avicenne Military Hospital of Marrakech. A 62-year-old diabetic male was admitted with fever, right upper quadrant abdominal pain, asthenia, and altered general condition. Laboratory investigations revealed marked inflammatory syndrome, leukocytosis, and hepatic cytolysis. Abdominal computed tomography demonstrated a multiloculated abscess in the right hepatic lobe. Percutaneous drainage was performed, and microbiological analysis of the aspirated pus isolated Pseudomonas aeruginosa. Antimicrobial susceptibility testing revealed susceptibility to piperacillin-tazobactam, ceftazidime and cefepime, associated with resistance to carbapenems, suggestive of OprD porin alteration phenotype. The patient received adapted intravenous antibiotic therapy associated with radiological drainage, resulting in favorable clinical and biological evolution. This observation highlights the importance of microbiological documentation in pyogenic liver abscesses and emphasizes the essential role of the microbiology laboratory in optimizing antimicrobial therapy and improving patient outcome.