TITLE:
Peptostreptococcus anaerobius-Related Hepatic Abscess Containing Abundant Monosodium Urate Crystals in a Patient without Gout: Report of a Case
AUTHORS:
Deonté Jefferson, Katellen Gomes, Nabil Barbara, James Cortez, Fernando Sanchez, Siegfried Pueblitz
KEYWORDS:
Hepatic Abscess, Anaerobic Bacteria, Purine Metabolism, Monosodium Urate Crystals, Gout
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.14 No.11,
November
6,
2025
ABSTRACT: Hepatic abscesses can develop in association with biliary disease, through hematogenous spread via the portal circulation, by continuity with an intra-abdominal infection, as a post-surgical complication or sepsis, and can be either bacterial (pyogenic) or parasitic (usually amoebic). We present the case of an 80-year-old woman with sepsis and a hepatic abscess that on microbiologic culture, grew Peptostreptococcus anaerobius but with an unusual finding of abundant monosodium urate (MSU) crystals in the purulent material. There are case reports of gouty tophi presenting as liver nodules as a first manifestation of gout in patients with underlying hepatic disease. However, to the best of our knowledge, this is the first report of MSU crystals within a pyogenic hepatic abscess in a patient without gout. We review the characteristics of gouty tophi and compare them to those found in the abscess cavity, as well as conditions under which MSU crystals are formed.