Blood tests at Tam Anh General Hospital Hanoi showed Ms. Hau’s white blood cell count slightly elevated at 11,79 G/L, while her procalcitonin (a blood protein) was high at 1,58 ng/mL, indicating an infection.

An abdominal MRI revealed a liver abscess measuring 36x47x52 mm, located near the liver capsule. A liver abscess is a collection of pus within the liver tissue, often linked to bacterial, tuberculosis, fungal, or parasitic infections. Based on an increased eosinophil count, doctors ordered a serological test. The results confirmed Ms. Hau was positive for dog/cat roundworm antibodies.

Doctor Nguyen Thi Thuy Hau, from the General Internal Medicine Department, stated that a large pus pocket carries a risk of complications or may not respond fully to medical treatment. Ms. Hau received intravenous antibiotics along with ultrasound-guided drainage of the abscess to remove the pus and control the infection.

During the intervention, doctors extracted about 30 ml of thick, greenish pus. Culture of the pus identified the bacterium *Streptococcus intermedius*.

*Streptococcus intermedius* can reside in the mouth or digestive tract of healthy individuals, but under certain conditions, it can cause deep infections and form abscesses in organs, including the liver. Following the culture and antibiogram results, doctors selected appropriate medication, while continuing drainage and monitoring the abscess size.

After 5 days of treatment, the patient's fever subsided, chills stopped, and fatigue lessened. The drainage tube no longer discharged pus, inflammatory markers in the blood decreased, and ultrasound showed the abscess shrinking. Ms. Hau was discharged after 10 days, her general condition stable, and she continued antibiotics to complete the course and for follow-up.

Doctors examining Ms. Hau before her hospital discharge. Photo: Tam Anh General Hospital

Dog/cat roundworm (*Toxocara*) is a parasite that can infect humans through contact with worm eggs from contaminated soil, sand, or environments with dog or cat feces.

Once inside the body, larvae can migrate through tissues, causing visceral larva migrans syndrome. The liver is one of the organs that can be affected, leading to fever, fatigue, abdominal pain, or an increase in eosinophils.

Doctor Hau advises pet owners to wash their hands after contact with pets, especially before eating or preparing food. It is also important to maintain a clean living environment, dispose of pet waste properly, and have dogs and cats checked and dewormed according to veterinary instructions.

Individuals experiencing prolonged unexplained fever, fatigue, or unusual abdominal pain should seek medical examination for diagnosis and treatment. Early detection and treatment of a liver abscess help control symptoms and prevent the abscess from rupturing, which could cause infections or pneumonia.

Thanh Ba