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Results for “Liver Abscess, Pyogenic”

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At least 649 records · Page 36Linked to original sources
PubMed1997

Tropical liver abscess.

Forty-one consecutive cases of liver abscesses seen at the National University Hospital, Singapore from 1988 to 1994 were reviewed. Twenty-seven cases (65%) were pyogenic, six (15%) amoebic, two (5%) tuberculous and six (15%) indeterminate. The predominance of pyogenic abscesses is in marked contrast to previous studies from the region a decade ago in which amoebic abscesses were the commonest type. The commonest pathogen causing pyogenic abscess was Klebsiella pneumoniae. Two cases were due to Mycobacterium tuberculosis, and this organism needs to be actively looked for in smears and cultures of aspirated material. As the majority of organisms isolated were resistant to ampicillin, empirical antibiotic treatment for suspected pyogenic abscess should include gentamicin or a cephalosporin. Percutaneous needle aspiration of the abscess was performed for 85% of pyogenic abscesses and surgery was necessary in only two cases because of complications. We found that percutaneous aspiration of liver abscess is helpful to confirm the diagnosis, provides a better bacteriological culture yield, gives a good outcome, and may uncover clinically unsuspected conditions like malignancy and tuberculoma which may mimic the presentation of liver abscesses. We recommend routine cytological examination of aspirated abscess material as well as stains and cultures for acid-fast bacilli.

Adult↗
PubMed1988

Hepatic abscess and cystic fibrosis.

Extrapulmonary infection is rare in cystic fibrosis. We describe two adult patients with cystic fibrosis whose course was complicated by the development of liver abscesses. The possible aetiology of these abscesses is discussed and the diagnosis, treatment and prognosis of pyogenic hepatic abscess is briefly reviewed.

Adult↗
PubMedDate not supplied

Diffusion-weighted MR imaging of the liver: distinguishing hepatic abscess from cystic or necrotic tumor.

BACKGROUND: We evaluated the ability of diffusion-weighted (DW) magnetic resonance (MR) imaging to differentiate between hepatic abscess and cystic or necrotic liver tumor. METHODS: DW MR imaging was performed in 18 patients who had liver masses with large cystic or necrotic cavities detected by computed tomography or ultrasonography. The final diagnoses were pyogenic abscess (five cases), fungal abscess (one), hepatocellular carcinoma (five), cystic metastasis (four), and hepatic cyst (three). Signal intensities on the DW images and apparent diffusion coefficient (ADC) maps were noted. ADCs in all lesions were calculated and compared with Student's t test. RESULTS: All lesions, except hepatic cysts, showed either heterogeneous or homogeneous rim enhancement on postgadolinium images. All abscess cavities showed hyperintensity on DW images and hypointensity on ADC maps. Conversely, the cystic or necrotic portions of all tumors showed hypointensity on DW images and hyperintensity on ADC maps. The mean ADCs (mm(2)/s) were 0.67 +/- 0.35 x 10(-3) in hepatic abscess, 2.65 +/- 0.49 x 10(-3) in cystic or necrotic tumor, 2.93 +/- 0.52 x 10(-3) in hepatic cyst, and 1.98 +/- 0.37 x 10(-3) in normal liver parenchyma. CONCLUSION: DW MR imaging, with the help of ADCs, may be a useful noninvasive imaging technique in differentiating hepatic abscess from cystic or necrotic tumor.

Cysts↗
PubMed1992

Pyogenic hepatic abscess and septic pulmonary emboli associated with Klebsiella ozaenae bacteremia.

We have reported a case of cryptogenic liver abscess with bacteremia and septic pulmonary emboli due to Klebsiella ozaenae. This organism has not previously been reported as a cause of intra-abdominal infection and this is only the eighth reported case of bacteremia. K ozaenae is generally considered an opportunist of low virulence and a respiratory tract colonizer implicated in ozena (atrophic rhinitis). More information is required to understand the epidemiology and pathogenicity of human disease caused by K ozaenae.

Aged↗
PubMed1998

A vanishing liver abscess complicated with Klebsiella pneumoniae chest wall abscess: a case report.

Septic metastasis is a unique feature of Klebsiella pneumoniae liver abscess in Taiwan. The case we report is a vanishing K. pneumoniae liver abscess with septic metastasis of the chest wall. The initial finding of a 36 year-old male with no previous medical history, was a huge hepatic mass presented on the sonography during a physical checkup. Hepatitis B, C serology, tumor markers and evidence of metastatic diseases were all negative. A computerized tomography examination was also inconclusive about its nature. Due to the patient's refusal of a liver biopsy, only oral antibiotics were medicated at the outpatient department. Unexpectedly, the follow-up computerized tomography, taken 4 weeks later, demonstrated that the liver mass was nearly absent, while a protruding painful lesion developed over the right chest wall. Under sono-guided aspiration, the chest wall mass was proved to be a pyogenic abscess. The Gram stain revealed gram-negative bacilli and the bacterial culture yielded K. pneumoniae. Under the impression of K. pneumoniae liver abscess with chest wall septic metastasis, after performing percutaneous drainage of the chest wall abscess, the patient was only given parenteral antibiotics for treatment. Both the liver and the chest wall abscesses were at last completely eradicated.

Adult↗
PubMed1987

Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur.

We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics.

Adult↗
PubMed2001

Liver abscesses associated with stromal tumour of the stomach in a young woman.

A 23-year-old Japanese woman was admitted to hospital because of pyrexia and anaemia. She was found to have liver abscesses and a gastric submucosal mass by computed tomography and ultrasonography. Gastroscopy and a barium swallow revealed a round submucosal mass with a giant ulceration in the body of the stomach. The liver abscesses were successfully treated by percutaneous transhepatic drainage and intravenous administration of antibiotics. Cultures of the fluid from a liver abscess and gastric juice yielded alpha-haemolytic streptococci. Three weeks after the drainage, partial gastrectomy was performed. The tumour was diagnosed as a stromal tumour of the stomach (leiomyosarcoma) in the final histological report. The patient was discharged on postoperative day 17 without receiving adjuvant radio-chemotherapy. There have been no signs of recurrence two years after surgery. This is a rare case of a liver abscess associated with a stromal tumour of the stomach in a young patient. The bacteriological examinations suggested a possible association between these diseases.

Adult↗
PubMedDate not supplied

Diabetes mellitus and Klebsiella pneumoniae liver abscess in adults.

Klebsiella pneumoniae hepatic abscess in five diabetic patients is reported. The recognition of a possible association between diabetes mellitus and pyogenic hepatic abscess, especially solitary ones, is highlighted. The clinical presentation including metastatic complications and the need for early diagnosis and institution of therapy are emphasized. Needle aspiration under ultrasonography is advocated and culture for anaerobes is stressed.

Adult↗
PubMed1986

Differentiation of pyogenic from amebic hepatic abscesses.

Recent immigration trends have resulted in an increased prevalence of amebic hepatic abscesses in southern states and in many northern American cities. Because amebic hepatic abscesses generally do not require drainage, differentiation from pyogenic hepatic abscesses is important. We, therefore, reviewed the records of patients admitted to the UCLA Medical Center from 1968 through 1983 to compare the clinical manifestations and to access the results of treatment of pyogenic and amebic hepatic abscesses. During this 15 year period, 82 patients (42 pyogenic and 40 amebic) with hepatic abscesses were admitted. Factors which distinguished patients with pyogenic abscesses included: age greater than 50 years; jaundice; pruritus; sepsis and shock; a palpable mass; elevated bilirubin level; elevated alkaline phosphatase level, and abnormal abdominal roentgenograms. Patients with amebic abscesses of the liver were more likely to have Mexican ancestry, recently traveled to an endemic area, abdominal pain, diarrhea, abdominal tenderness, hepatomegaly and positive amebic serology. Hepatic scans and ultrasonography were excellent methods of detecting the presence of but not the type of hepatic abscess. Over-all, the mortality was 40 per cent for patients with pyogenic abscesses whereas all 40 of the patients with an amebic abscess survived. However, operative mortality was only 4.5 per cent for the 22 patients with pyogenic abscess who were managed with systemic antibiotics and surgical drainage. We conclude that many clinical and laboratory parameters can aid in the differentiation and, as a result, management of patients with pyogenic and amebic hepatic abscesses.

Adolescent↗
PubMed1991

[The relationship between predisposing factors in liver abscesses and the causative bacteria].

In order to assess the correlation between bacteria isolated from liver abscesses and factors predisposing to liver abscesses, a retrospective study of clinical and bacteriological data on 21 patients with 27 episodes of pyogenic abscesses was carried out at the University Medical Centre, Amsterdam. Out of 27 episodes, 15 (55%) were associated with biliary or pancreatic disease; in seven of these 15 episodes more than one microorganism was cultured. Enterobacteriaceae were isolated in 13 (85%) of 15 episodes. Anaerobic bacteria were recovered only when operations in the pancreatico-biliary area had been performed previously. Seven episodes (26%) were related to extrahepatic disease; anaerobic bacteria (Bacteroides and Fusobacterium spp.) were isolated in five of these seven episodes. Streptococcus milleri seemed especially prominent, since this bacterium was cultured in six of seven episodes. Enterobacteriaceae were not involved in these seven episodes. Other factors predisposing to liver abscesses (15%) were diabetes mellitus n = 2), paraproteinaemia (n = I), and metastatic carcinoid (n = I). Blood cultures were positive in 65% of 23 episodes, but 40% of the positive cultures contained a smaller number of bacterial species than could be cultured from the abscess itself. Bacteria isolated from liver abscesses are related to the underlying predisposing condition. For diagnosis of the underlying condition and antibiotic therapy, puncture and bacteriologic examination of the abscess is essential.

Adult↗
PubMed1990

Interest of gallium hepatic scintigraphy in hepatic abscess: a case study.

The interest of 67Ga-citrate scintigraphy in the diagnosis of hepatic abscess is illustrated by a study of a 56-year-old man, who was admitted to the hospital for upper abdominal pain. Ultrasound (US) and X-ray CT scan examinations suggested the presence of a liquid mass, the origin of which was unclear. Liver scintigraphy with 67Ga-citrate disclosed a lacunar zone surrounded by a rim of increased uptake, an image strongly suggestive of abscess or necrotic tumor. A US-guided needle aspiration of the hepatic mass yielded a purulent liquid, from which Streptococcus milleri were grown. This observation suggests that, despite the development of other diagnostic procedures, hepatic gallium scintigraphy still remains sometimes useful for the investigation of poorly characterized hepatic masses.

Citrates↗