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Results for “Liver Abscess, Pyogenic”

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PubMed1982

Transcutaneous drainage of abscesses of the liver guided by computed tomography scan.

Six instances of pyogenic abscess of the liver, diagnosed and localized by computed tomography scan, showed dramatic improvement after treatment by needle aspiration and antibiotics or precutaneous continuous aspiration and antibiotics. An intercostal trocar drain, 18F, was used to obtain optimal drainage also of viscous purulent material and debris. After drainage was begun, improvement was rapid and without complication or mortality. We have collected from the literature 59 patients with abscesses of the liver treated by the same methods with a surprisingly low mortality, 1.5 per cent. It seems that the continuous percutaneous drainage of the pyogenic abscess of the liver, guided by computed tomography scan or ultrasonography, may be the method of choice and that open surgical drainage should be limited to special instances.

Adolescent↗
PubMed1989

Liver abscesses.

Clinical suspicion of a liver abscess mandates an investigation of the liver for evidence of a liver abscess by radionuclide, ultrasound, or CT scan. Amebic abscesses have a lower mortality rate than pyogenic abscesses. Amebic and pyogenic abscesses can be distinguished on the basis of epidemiologic, clinical, and laboratory studies. The definitive studies for identifying amebic liver abscesses are hemagglutinin or gel diffusion studies. Amebic abscess of the liver may be complicated by extension to the lung, with pulmonary complications. Patients suspected to have amebic abscesses require metronidazole. Emetine or chloroquine may be added if there is no response or if the abscess recurs. Unless there is a failure of the amebic abscess to resolve or secondary infection occurs, there is seldom a need to aspirate or drain these abscesses. Pyogenic abscesses should be treated with broad-spectrum antibiotics to cover gram-negative aerobes and anaerobic organisms. All pyogenic abscesses larger than 1.5 cm in diameter should be aspirated, and the aspirate should be Gram stained and cultured. Percutaneous or surgical drainage should then be performed. Operative intervention is required in those patients with intra-abdominal pyogenic infections that are seeding the liver abscess. The marked reduction in the mortality rate of pyogenic liver abscess witnessed in this decade is multifaceted and attributable in part to earlier diagnosis, permitting definitive treatment in a timely fashion, as well as to improved intensive unit care, antibiotic management, and operative technique.

Adult↗
PubMed1994

[Clinical aspects, etiology, diagnosis and therapy of liver abscess. A retrospective study 1984-1991].

In a retrospective study (1984-1991) we evaluated 56 patients with pyogenic (44 patients) and with amebic (12 patients) liver abscesses. Patients with pyogenic liver abscesses usually belong to the older generation (70-80 years). Pyogenic abscesses are mainly due to a severe underlying disease and patients are in poor general condition. Therapy includes antibiotics and in most cases drainage (nowadays mainly percutaneous; surgical drainage should only be used with a simultaneous intraabdominal procedure for treatment of the underlying disease). The mean hospitalization time is 33 days. Prognosis is good, the mortality of 14% being mainly due to severe underlying disease. This latter can be found in 75% of the patients and should be treated electively. In amebic liver abscesses the patients are much younger (around 30 years). Patients are in good general condition and antibiotics alone are sufficient for radical treatment. The mean hospitalization time is 16.5 days and mortality is zero. Symptoms and clinical signs are the same in both groups: fever, right upper quadrant tenderness, jaundice and hepatomegaly. Diagnosis by ultrasonography and/or computed tomography is very reliable. History and serology are reliable for differentiation of the two types. With a correct diagnostic approach and treatment, liver abscesses are today benign conditions with a low mortality.

Adult↗
PubMed1999

[Hepatic tuberculosis of the pseudotumoral form].

The authors report a case of a 30 years old immunocompetent woman with liver tuberculosis with an unusual pseudotumoral presentation and secondary occurrence of abcedation with cutaneous fistulization. The diagnosis was based on the bacteriological positivity for acido-alcoolo resistant bacillus in pus of the abscess obtained by ponction guided by ultrasonographic examination. The authors emphasize in the differential diagnosis with the other causes of liver abscess (amibiasis and pyogenic microorganisms) and liver carcinoma. They also note the importance of the function guided by ultrasonographic examination permitting histologic and bacte+ériologic study in the diagnosis of this unusual presentation of liver tuberculosis. The patient was treated by antibacillary antibiotics and evacuation function. The prognostic was good with 6 months of follow-up.

Adult↗
PubMed1999

Bacterial flora of liver abscesses in feedlot cattle fed tylosin or no tylosin.

Bacterial flora of liver abscesses from cattle fed tylosin or no tylosin and susceptibilities of the predominant bacterial isolates to tylosin and other antimicrobial compounds were determined. Abscessed livers were collected at slaughter from cattle originating from feedlots that had fed tylosin (n = 36) or no tylosin (n = 41) for at least 2 yr, and segments of livers with one or two intact abscesses were transported to the laboratory. Abscesses were cultured for anaerobic and facultative bacteria. Fusobacterium necrophorum, either as single culture or mixed with other bacteria, was isolated from all abscesses. The incidence of subsp. necrophorum, as part of the mixed infection, was lower (P < .05) in the tylosin group than in the no-tylosin group (33 vs 61%). However, the incidence of Actinomyces pyogenes was higher (P < .01) in the tylosin group than in the no-tylosin group (53 vs 10%). Totals of 119 F. necrophorum and 21 A. pyogenes isolates were used for determinations of susceptibilities to bacitracin, oxytetracycline, chlortetracycline, lasalocid, monensin, tylosin, tilmicosin, and virginiamycin. The minimum inhibitory concentrations (MIC) of antibiotics were determined with a broth microdilution method. The mean MIC of tylosin for F. necrophorum and A. pyogenes were not different between isolates from tylosin and no-tylosin groups. We concluded that continuous feeding of tylosin did not induce resistance in F. necrophorum or A. pyogenes. Also, the higher incidence of mixed infection of F. necrophorum and A. pyogenes in liver abscesses of tylosin-fed cattle suggests a potential synergistic interaction between the two organisms in causing liver abscesses.

Actinomyces↗
PubMed1981

Therapeutic utilization of laparoscopy in liver abscess cases.

Recently, the authors encountered a case of a bacterial pyogenic abscess of the liver in which the localization of a solitary abscess in the right hepatic lobe could be delineated on the basis of the findings of a physical examination, sonography, scintigraphy, computer tomography and selective angiography. The popularization of endoscopic surgery and chemotherapy encouraged us to attempt drainage of the pus out of the pyogenic abscess under laparoscopic observation. The patient has been progressing favorably thereafter and now about ten months have passed since he returned home. He is in good health. Clinical utilization of laparoscopy is possible from a therapeutic standpoint in solitary abscess of the liver.

Drainage↗
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↗
PubMed2006

Percutaneous aspiration versus open drainage of liver abscess in children.

Liver abscess, though a very grave problem, is rarely seen in infancy and childhood. Affected children are usually immunocompromised and are of poor socioeconomic status. Although liver abscess due to wandering ascarids is rare outside, it is common complication among children of Kashmir. Usual site of abscess is the right lobe of the liver and USG and CT of the abdomen are the main tools of diagnosis. The study was conducted over a period of 10 years from January 1991 to December 2000 and total of 129 cases were studied in the age group of 0-14 years. Diagnosis was made by a detailed clinical examination together with USG and CT of the abdomen. Out of 129 cases, 49 were treated with antibiotics alone, 55 cases were taken for open drainage, and 27 cases were taken for percutaneous aspiration under USG guidance. Percutaneous aspiration failed in five patients who were later taken for open drainage. Open method was found still to be the best modality of management, although percutaneous aspiration is safe and effective but needs lot of expertise.

Adolescent↗
PubMedDate not supplied

Thrombophlebitis of the hepatic veins: complication of a Klebsiella liver abscess.

Among the various causative agents of an abscess of the liver, Klebsiella is a frequent and well-known cause, and its imaging findings have been described in the past decades. We report two cases of this type of abscess, which were of interest because of associated findings indicating a subhepatic thrombophlebitis of the liver, a process which could have explained the development of a concomitant pulmonary infectious process.

Adult↗
PubMed2005

Hepatic abscess.

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Adult↗