A novel method for treatment of pseudomonas pyogenic hepatic abscess complicating an echinococcal cyst by irrigation with acetic acid. A case report and literature review

Hepatic hydatid cysts can be complicated by pyogenic abscesses. We report a case of hepatic hydatid cysts presenting to Sultan Qaboos University Hospital (SQUH) on 29 June 2010 complicated by secondary infection with fully sensitive Pseudomonas aeruginosa. The infection persisted despite standard treatment (drainage and systemic antibiotics) and was eventually cured with a novel method using acetic acid. METHODSInstillation of acetic acid (in the form of white vinegar) into the hepatic abscess through the pig tail drainage tube. RESULTSThe administration of acetic acid (6%) in the form of white vinegar was well tolerated and safe to the patient and resulted in complete clinical and radiographic resolution of the hepatic abscess. CONCLUSIONAcetic acid (vinegar) irrigation can be used to clear a refractory pyogenic hepatic abscess due toP aeruginosa infection.