Lung and Cutaneous Abscesses in a Patient with Ulcerative Colitis: A Case Report and Literature Review

Abstract

Jing Ren,1,* Jiahua Zhou,2,* Qinhui Wang,1,* Linna Liu,1 Wei Liu,3 Shan Wang,4 Yao Zheng,1 Li Luo,1 Qi Yang1 1Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China; 3Department of Orthopedics, The Second Affiliated Hospital of Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China; 4Department of Pharmacy, New York University Langone Hospital – Long Island, Mineola, NY, USA*These authors contributed equally to this workCorrespondence: Qi Yang; Li Luo, Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi’an, Shaanxi, 710038, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected]; [email protected]: Aseptic abscess (AA) syndrome is a rare inflammatory disorder often associated with inflammatory bowel disease (IBD). Cases of IBD-associated AA have been reported in Japan, India, and Canada, but rarely in China. Herein, we present the case of a Chinese patient with IBD-associated AAs and review the literature on AA with underlying IBD. We report the case of a 48-year-old male patient with multiple AAs on his left hand and lungs who was successfully treated with prednisone. He had undergone cutaneous abscess incision and drainage twice in the previous 2 years. The patient presented to our hospital with ulcerative colitis and pain in the dorsum of the left hand. Pus from his hand and blood cultures revealed sterile cutaneous abscesses. Chest computed tomography examination during hospitalization revealed a lung abscess. The AA was unresponsive to cefotiam or cefoperazone-sulbactam. The patient’s left hand and lung conditions did not improve until prednisone was administered. The patient was followed up as an outpatient for 3 months and recovered without any clinical symptoms. We retrieved 17 cases of IBD-associated AA from the literature. None of the patients showed evidence of infection and failed antibiotic treatment, and all improved with corticosteroid use. AA may be an extra-intestinal manifestation of IBD. Effective medications include corticosteroids and immunosuppressive agents. This case may increase the awareness of AA and aid in early identification.Keywords: aseptic abscess, inflammatory bowel disease, ulcerative colitis, extra-intestinal manifestation

Keywords

• aseptic abscess
• inflammatory bowel disease
• ulcerative colitis
• extra-intestinal manifestation