Fatal fulminant septic shock with disseminated intravascular coagulation following percutaneous aspiration and sclerotherapy of a hepatic cyst: a case report.

Liver cysts are common benign lesions. Although percutaneous aspiration combined with sclerotherapy is a safe and effective treatment, severe infectious complications are rare but potentially fatal. This report describes a rare case of a 69-year-old female patient who underwent percutaneous aspiration and polidocanol sclerotherapy for multiple liver cysts. Postoperatively, she rapidly developed fulminant septic shock complicated by disseminated intravascular coagulation (DIC), ultimately resulting in death. Laboratory tests following onset of symptoms revealed significantly elevated inflammatory markers and coagulation disorders. Despite aggressive treatment with broad-spectrum antibiotics, fluid resuscitation, vasoactive agents, anticoagulation therapy, and continuous renal replacement therapy, the patient died within 24 h of the onset of shock. Escherichia coli was detected in both blood and cyst fluid cultures, suggesting a combined pathogenic mechanism involving both percutaneous puncture-related dissemination and biliary-intestinal bacterial translocation. This case demonstrates that percutaneous interventional treatment of liver cysts may lead to complications of fulminant infection, underscoring the critical importance of early recognition and timely intervention.