Pyogenic liver abscess: an unusual cause of preterm delivery

Background: Pyogenic liver abscess (PLA) is a rare and serious clinical entity during pregnancy, particularly in tropical regions where infectious diseases predominate. Fever is the most common symptom, but the diagnosis is often delayed due to its rarity and the overlap of symptoms with other tropical diseases. Clinical case: We report the case of a 29-year-old pregnant woman at 28 weeks of gestation presenting with altered consciousness, fever, and right hypochondrial pain. Initial investigations revealed intrauterine fetal death and a hepatic abscess. Management included intravenous antibiotics and surgical drainage after unsuccessful percutaneous aspiration. Despite maternal recovery, the fetal prognosis was poor, with intrauterine fetal death. Discussion: Prompt diagnosis and multidisciplinary management are crucial in managing PLA during pregnancy. Imaging techniques such as ultrasonography are pivotal for diagnosis, while empiric broad-spectrum antibiotics combined with drainage provide effective treatment. Conclusion: Although rare, PLA should be considered in pregnant women presenting with fever, especially in tropical regions. Early diagnosis and treatment are vital to minimize maternal and fetal complications. Keywords: Pyogenic liver abscess, preterm delivery, intrauterine fetal death, pregnancy complications, tropical infections.