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At least 433 records · Page 24Linked to original sources
PubMed1983

Perineal Crohn's disease complicated by pyogenic liver abscess during metronidazole therapy.

A patient with ileal and perineal Crohn's disease developed a pyogenic liver abscess caused by Streptococcus milleri. The perineal process had been treated with high-dose metronidazole for the preceding 6 mo, and culture of a perianal abscess 2 mo before admission revealed heavy growth of Streptococcus milleri (which was misidentified as an anaerobic Peptostreptococcus). This case illustrates the difficulty in correctly identifying Streptococcus milleri, the most frequent isolate from pyogenic liver abscesses. Furthermore, the events suggest that metronidazole therapy can allow overgrowth of this organism in perineal abscesses which, in turn, may predispose to the development of purulent foci such as liver abscesses. This effect on the bacterial ecology of the perineum should be considered when opting for metronidazole therapy of perineal Crohn's disease.

Adult↗
PubMed2005

Pyogenic liver abscesses secondary to carcinoma of the sigmoid colon: a case report and clinical features of 20 cases in Japan.

We report a case of liver abscesses associated with sigmoid colon cancer in an 81-year-old woman. The patient was referred to our hospital because of a tumorous lesion of the sigmoid colon. Five days before the scheduled operation, she presented abdominal pain, fever and chill. Imaging scans revealed multiple liver abscesses in both lobes, which were successfully treated with intravenously administered antibiotics. Two weeks later, the patient underwent laparoscopic-assisted sigmoidectomy. Nineteen cases of liver abscess associated with colonic cancer have been reported during the past ten years in Japan, and we report the clinical features of these cases in this paper. An aggressive search for the underlying cause of pyogenic liver abscess should be an integral part of the definitive treatment of this disease.

Aged, 80 and over↗
PubMed1984

Cellular bases of experimental amebic liver abscess formation.

The complete sequence of morphologic events during amebic liver abscess formation in the hamster has been studied, from the lodgement of amebas in the hepatic sinusoids to the development of extensive liver necrosis. Following intraportal inoculation of live amebas, the early stages of the lesion (from 1 to 12 hours) were characterized by acute cellular infiltration composed of an increasingly large number of polymorphonuclear leukocytes, which surrounded centrally located trophozoites. Histiocytes and lysed leukocytes were situated on the periphery of the lesions. Hepatocytes close to the early lesions showed degenerative changes which led to necrosis; however, direct contact of liver cells with amebas was very rarely observed. At later stages, the extent of necrosis increased, macrophages and epithelioid cells replaced most leukocytes, and well-organized granulomas developed. Extensive necrosis associated with fused granulomas was present by Day 7. The results suggest that Entamoeba histolytica trophozoites do not produce amebic liver abscesses in hamsters through direct lysis of hepatocytes. Rather, tissue destruction is the result of the accumulation and subsequent lysis of leukocytes and macrophages surrounding the amebas.

Animals↗
PubMed1997

Portal vein thrombosis and multiple liver abscesses in Crohn's disease--an example for successful conservative treatment.

We report about a 27-year-old patient with Crohn's disease presenting with two complications; Portal vein thrombosis and multiple liver abscesses. Conservative treatment with antibiotics and percutaneous catheter drainage was successful, the liver abscesses disappeared. 18 months later the patient presented in best condition. Ultrasound showed cavernous transformation of the portal vein system and splenomegaly, discrete esophageal varices were seen by esophagogastroscopy. This is an example for an excellent course under conservative therapy of liver abscesses, on the other hand it is the first reported case of a patient with a combination of portal vein thrombosis and multiple liver abscesses in Crohn's disease.

Adult↗
PubMed1994

Pyogenic liver abscess in children.

Our center's experience with 15 pyogenic liver abscesses in 14 children from 1979 to 1992 showed an incidence of 20 per 100,000 pediatric hospital admissions. Eight of the 15 liver abscesses were cryptogenic in origin. The clinical features and laboratory findings were non-specific. Improved imaging techniques such as real time sonography and computed tomography made early diagnosis feasible. Klebsiella pneumoniae was the most common pathogen in this study. Drainage combined with antibiotics provides the most important treatment for this disease. Before 1986, surgery was frequently used, but now percutaneous drainage is preferred. Surgery may be reserved for those who respond poorly to percutaneous drainage and medical treatment. One of the 14 patients in this study died.

Adolescent↗
PubMed2005

Candidal liver abscesses and cholecystitis in a 37-year-old patient without underlying malignancy.

We report a case of candidal liver abscesses and concomitant candidal cholecystitis in a diabetic patient, in whom differences were noted relative to those found in patients with hematologic malignancies. In our case, the proposed entry route of infection is ascending retrograde from the biliary tract. Bile and aspirated pus culture repeatedly tested positive, and blood negative, for Candida albicans and Candida glabrata. Cholecystitis was cured by percutaneous gallbladder drainage and amphotericin B therapy. The liver abscesses were successfully treated by a cumulative dosage of 750 mg amphotericin B. We conclude that in cases involving less immunocompromised patients and those without candidemia, a lower dosage of amphotericin B may be adequate in treating candidal liver abscesses.

Adult↗
PubMed1984

Amoebic liver abscess in pregnancy. Case reports.

Amoebic liver abscess is a rare complication of pregnancy. Two patients are described, one of whom was diagnosed at laparotomy at 28 weeks gestation, after which the pregnancy progressed normally to term. Diagnostic features and the importance of early treatment with metronidazole and aspiration or laparotomy are discussed.

Adult↗
PubMedDate not supplied

Bile peritonitis due to ruptured amoebic liver abscess.

A fatal case of bile peritonitis due to ruptured amoebic liver abscess is reported. Exudation of bile from a solitary abscess within the liver was the cause of the biliary peritonitis. Secondary bacterial peritontis and Gram negative septicaemia were complications and their clinical significance has been discussed.

Amebicides↗
PubMed1983

Pyogenic liver abscess.

The primary source of pyogenic liver abscess is undetermined in about 30 percent of cases. Escherichia coli, microaerophilic streptococci and Bacteroides fragilis are among the common pathogens. Some cases can be treated with antibiotics alone; others require surgical management. With improved methods of diagnosis and therapy, the mortality rate is now 10 percent or less.

Adult↗
PubMed1976

[Serum-antibodies in patients with extra-intestinal amoebiasis (amoebic liver abscess) and healthy persons (author's transl)].

Tests for serum antibodies against two amoeba antigens were performed on serum samples from 70 patients with amoebic liver abscesses, 204 travellers returning from tropical countries and 136 inhabitants of an endemic region without evidence of amoebiasis. Suspicious or borderline results in the complement-fixation, indirect haemagglutination, latex-agglutination, and double-gel diffusion tests occurred in 73.3%-90.4% of patients with amoebic liver abscess, in the same reactions (except double-gel diffusion test) in 12.1-18.9% of travellers in the trophics, and 16.2%-46.3% of inhabitants of endemic regions. There was evidence for the need of performing several tests: patients with amoebic liver abscesses gave diagnostically useful results the more frequently the more tests were performed on a given serum sample. Negative results in the three tests occurred in only one case of multiple liver abscesses, but the sample had been obtained very early.

Antibodies↗
PubMed1996

Prognostic markers in amebic liver abscess: a prospective study.

OBJECTIVES: Amebic liver abscess (ALA) is being increasingly recognized with the progressive spread of AIDS. The prognosis of ALA needs to be determined to decide whether aggressive intervention therapy should be used. A prospective study was conducted to determine the factors that predicted mortality in patients with ALA. METHODS: The study population consisted of 135 consecutive patients with ALA who were treated with 80 mg/kg/day of metronidazole for 10 days if they survived. Needle aspiration or open surgical drainage was performed in patients who deteriorated despite drug therapy or had an abscess that clinically appeared to be at risk of impending rupture. Survivors and nonsurvivors were compared by univariate and multivariate analysis to identify predictors of outcome. These predictors were then prospectively evaluated in a subsequent cohort of patients with ALA. RESULTS: Twenty-four patients died during the acute phase. Significant differences between survivors and nonsurvivors were observed. A stepwise logistic regression suggested that a bilirubin level >3.5 mg/dl, encephalopathy, volume of abscess cavity, hypoalbuminemia (serum albumin level <2.0 g/dl), and the number of abscesses were independent risk factors for mortality. The duration of symptoms and type of treatment did not influence mortality. The regression equation derived was then applied prospectively to 64 subsequent patients with ALA, and the validity of the prediction rule was confirmed. The qualities of simplicity, availability, low cost of derivation, and good discriminating power suggest that this index would be useful in assessing prognosis in patients with ALA.

Adult↗
PubMed1977

Comparative study of tinidazole and metronidazole in amoebic liver abscess.

Twenty proven cases of amoebic liver abscess were treated at random with either tinidazole or metronidazole. The dose of both was 2 g once daily for 2 days. Clinical, radiological, and biochemical follow-up was done for 30 days. Of the 19 patients who completed the trial, complete recovery was observed in all 10 patients given tinidazole and in 5 of 9 patients given metronidazole (p=0.05). Moreover, patients on tinidazole required repeat aspirations less frequently than those on metronidazole. Mild gastrointestinal side-effects occurred in 1 patient on metronidazole. The results suggest that tinidazole is a more efficacious drug than metronidazole, with rapid therapeutic effect.

Adult↗
PubMed1975

Liver abscess due to ascarid in Iran.

A deep 3-cm liver abscess with resulting exogenous cholecystitis, pericholecystitis and adhesions caused by an adult Ascaris was discovered by laparotomy in a 63-year-old man in northwest Iran. Though Ascaris infection rates are high in most major areas of the country, this apparently is the first case of liver abscess caused by Ascaris to be reported from Iran.

Ascariasis↗
PubMed1992

Early detection of complications in amebic liver abscess.

A retrospective analysis of 140 cases with amebic liver abscess (ALA) seen at the AUNL University Hospital was done to see if patients with complications can be identified earlier in order to decrease morbidity and mortality. Sixteen patients (11.4%) presented complications and six patients died (4.2%). Patients with complications presented jaundice, large or multiple abscesses, acute abdomen, liver failure and sepsis more often than patients without complications. Hemoglobin, hematocrit, prothrombin time, total proteins, albumin, LDH, and BUN were more altered in patients who presented complications. The titer of antibodies against E. histolytica was higher in this group of patients. The six patients who died had been operated on. The causes of death were septic shock in two, sepsis in one, peritonitis in one, liver failure in one and colon perforation in one patient. Pleural effusion, jaundice and acute abdomen were seen in three patients, respectively (50%), two cases had multiple abscesses (33.3%), one patient had a ruptured abscess (16.7%). Patients who died exhibited more alterations in six laboratory examinations at admission: partial prothrombin time, total bilirubin, albumin, BUN, LDH, and leukocytes. Clinical data together with the severe alterations in laboratory examinations at admission for patients with ALA should alert the clinician to suspect complications earlier in order to decrease morbidity and mortality.

Abdomen, Acute↗
PubMed2001

Human toxocariasis and pyogenic liver abscess: a possible association.

OBJECTIVES: To study the role of human toxocariasis in the pathogenesis of pyogenic liver abscess. METHODS: We compared the serology for toxocariasis and serum levels of IgE in 16 patients with pyogenic liver abscess to those in 32 matched (age and gender) controls to define the possible association between these two entities. RESULTS: The serology for toxocariasis was positive in 10 of 16 patients compared with 4 of 32 controls. The relative odds and 95% confidence interval (conditional logistic regression), comparing cases and matched controls, was significant (1.4; 95% confidence interval, 1.1-1.7) for Toxocara serology. Regarding IgE serum levels, there was no difference between cases and controls. CONCLUSIONS: Human toxocariasis can be one of the predisposing causes of pyogenic liver abscess, especially in tropical countries in which this parasitic disease is common. Treatment of human toxocariasis may prevent morbid complications like hepatic abscess and should be considered in patients with clinical and/or serological evidence of Toxocara infection.

Adolescent↗
PubMed2000

Hepatocellular carcinoma presenting as a pyogenic liver abscess in a patient with hemochromatosis.

Primary hemochromatosis is rare in Taiwan. Hepatocellular carcinoma (HCC) is endemic in Taiwan, but HCC with initial presentation as pyogenic liver abscess is unusual. We report a case of HCC presenting as pyogenic liver abscess in a hemochromatotic patient with cirrhosis. The patient underwent hepatectomy and had a smooth postoperative course. Unfortunately, he died of pneumonia eight months after surgery. HCC should be considered in the differential diagnosis in hemochromatotic patients with a pyogenic liver abscess.

Aged↗
PubMedDate not supplied

[Studies on liver abscesses (author's transl)].

The authors report 25 observations of liver abscesses in the same service over a 5 years period. Diagnostic difficulties are pointed out and the value of echography, a simple and well tolerated examination, are emphasized immunologic studies allow the differentiation of the two types off liver abscesses i.e., pyogenic and amoebic, thus orientating their different treatments. The treatment of pyogenic abscesses (12 cases) is chiefly surgical, supported with suitable antibiotic therapy. Amoebic abscesses require medical treatment in collected abscesses of little or mean volume. In our series the number of patients requiring surgery is important (13 cases). This is due to persisting residual pouches or to the absence of well defined cliical improvement with medical treatment and the occurence of pre-burst or burst symptoms.

Adult↗
PubMed1996

A successfully treated case of multiple liver abscesses accompanied by portal venous gas.

A case with multiple liver abscess accompanied by massive portal venous gas is reported. A 61-yr-old male was admitted because of left lower abdominal pain, fever, and diarrhea. Abdominal x-ray examination demonstrated multiple branching lucencies in the liver. Computed tomography revealed multiple liver abscesses and massive gas in the portal system as well as a thickened wall of the sigmoid colon. Enema study using contrast medium revealed a perforation of the sigmoid colon with diverticulitis. The outcome was favorable after sigmoid colectomy in addition to intensive treatment with antibiotics. Bacteroides fragilis, which produces gas (H2 and NH3) by fermentation, was isolated not only from the resected specimen but also from blood samples. Although the presence of portal venous gas is a sign of poor prognosis in patients with intestinal infectious diseases, the sensitive detection of hepatic portal venous gas by computed tomography and the appropriate treatment may improve the patient's prognosis.

Anti-Bacterial Agents↗