Kyra Hunsberger,Burke De Lange,
Laparoscopic Appendectomy Turned Hepatotomy Revealing Rare Streptococcus Species: A Case Report
American Journal of Surgical Case Reports
2025
2674-5046
http://dx.doi.org/10.31487/j.AJSCR.2025.01.02
https://www.sciencerepository.org/laparoscopic-appendectomy-turned_AJSCR-2025-1-102 
Abstract: While appendicitis is a common surgical emergency, progression to hepatic abscess due to rare microbial species is an unusual complication. We present the case of a 55 year-old male with past medical history of hypothyroidism presenting with one week of fever, cough, rigors, dyspnea, and generalized abdominal pain. He was diagnosed with viral gastroenteritis at urgent care but presented to the emergency room a week later where subsequent CT scan revealed appendiceal inflammation and hepatic abscess. He underwent laparoscopic appendectomy and hepatotomy, revealing perforated appendicitis, appendiceal abscess, localized peritonitis, and a hepatic abscess. Microbiology identified viridans streptococcus, citrobacter koseri, streptococcus intermedius, and streptococcus gordonii. He was treated with broad-spectrum antibiotics and additional percutaneous drainage. He was discharge on a 30-day course of oral antibiotics. This case highlights an unusual complication of appendicitis leading to hepatic abscess with rare bacterial isolates. Surgical intervention and targeted antimicrobial therapy were key in managing this patient.Keywords: Appendiceal perforation, hepatic abscess, microbiology, streptococcus, surgery