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At least 667 records · Page 37Linked to original sources
PubMed1995

[Multiple candida liver abscesses successfully treated by continuous intrahepatic arterial infusion of amphotericin B using a reservoir in a case with acute myelocytic leukemia (M2)].

A 49-year-old male was admitted with a diagnosis of AML (M2). One course of BHAC-DM regimen induced complete remission. During the consolidation therapy, he developed marked pyrexia resistent to antibiotics. Ultrasonography and CT scan revealed multiple small liver abscesses, which suggested mycotic etiology. After unsuccessful treatment with intravenous administration of fluconazole, a percutaneous transhepatic intraportal administration of Amphotericin B (AMPH-B) (20 mg/day) was started, followed by the consolidation chemotherapy. When the first positive blood culture was obtained for Candida, a reservoir was embedded in the subcutaneous layer of the right iliac region and the intrahepatic arterial administration of AMPH-B (5 to 20 mg/day) by the Infusor (Baxter Healthcare Corporation), a portable, disposable drug delivery system that provides a constant drug flow, was started. The liver abscesses has almost disappeared when the maintenance chemotherapy was completed. The side effects of AMPH-B were negligible. This case suggests the usefulness of the intrahepatic arterial infusion of AMPH-B using an inplantable drug delivery system in patients with hematological malignancies developing intractable multiple fungal liver abscesses.

Amphotericin B↗
PubMed1991

[Successful reinduction of complete remission in a patient with ALL associated with multiple liver abscesses who relapsed after 6 years].

We reported on a 35 year-old patient suffering from ALL with multiple liver abscesses (Journal of Kyusyu Hematological Society, Vol. 31, No. 3 & 4, Dec., 1983). He experienced six years of complete hematological remission from 1983 to 1989, with low fever, positive CRP, polyclonal gamma-globulinemia and elevated alkaline phosphatase. A relapse occurred in June of 1989. A subsequent biopsy revealed fibrosis of the liver attributed to inflammation. At present, he has returned to the complete remission stage with no exacerbation of the liver abscesses.

Adult↗
PubMed1983

Discordant Tc-99m sulfur colloid and In-113m chloride blood pool images in patients with acute amebic liver abscess.

Using combined Tc-99m sulfur colloid and In-113m chloride eluate imaging, studies from 32 patients with proven amebic liver abscess were analyzed. The results revealed good perfusion of the amebic lesion in three, poor perfusion in 11, and absent perfusion in 18. These results appear to depend on abscess size and age. Images with In-113m seem to be better than those with Tc-99m sulfur colloid in depicting amebic liver abscess during antiamebic therapy. Overall, the In-113m images provide more precise information concerning abscess size and shape.

Acute Disease↗
PubMed2001

Pylephlebitis, portal-mesenteric thrombosis, and multiple liver abscesses owing to perforated appendicitis.

The authors report a case of a ruptured retrocecal appendix presenting with pylephlebitis, portal-mesenteric thrombosis, and multiple liver abscesses in an 8-year-old boy. A right hemicolectomy was performed, and liver abscesses were drained. The patient was treated with long-term antibiotics and anticoagulation. This the only case of perforated appendicitis associated with these 3 morbid complications in the modern literature.

Anti-Bacterial Agents↗
PubMed1994

[A successful delivery three years after the onset of multiple fungal liver abscess in a patient with acute lymphoblastic leukemia].

A 25-year-old woman was diagnosed as having the multiple fungal liver abscess which developed just after the re-induction chemotherapy, 13 months after the onset of acute lymphoblastic leukemia. Although chemotherapy for leukemia was suspended, her leukemia did not relapse. The multiple fungal liver abscess was successfully treated with anti-fungal drugs for the following 12 months. Three years after the onset of the fungal abscess, she married, became pregnant and vaginally delivered a healthy female infant at full term. In this way, it was demonstrated that a normal pregnancy and delivery could be expected even in patients who had received intensive chemotherapy and had recovered from the fungal abscess.

Adult↗
PubMed1999

Amebic liver abscess: changing trends over 20 years.

Amebiasis and amebic liver abscess (ALA) continue to be a major fatal disease in developing countries where unhygienic environmental conditions prevail. Between January 1975 and December 1984 there were 60 patients and from January 1985 to December 1994 there were 44 patients with ALA who were diagnosed and treated. In the first group, all patients were operated on, and drainage was performed. The morbidity and mortality rates were 53.3% and 23.3%, respectively. Metronidazole was given to all patients in the second group, and in those who did not respond to the metronidazole percutaneous needle aspiration was applied. Surgical treatment was performed in seven patients because four did not respond to metronidazole therapy and percutaneous needle aspiration, and in three the abscess ruptured into the peritoneal cavity. The lesion disappeared ultrasonographically after 4 months in all patients. The morbidity and mortality rates were 4.5% and 2.2%, respectively. The result of this study suggests that uncomplicated ALA can be managed conservatively with metronidazole and needle aspiration of the abscess. Operative therapy should be performed for complications of the abscess and when conservative therapy fails.

Adult↗
PubMed2004

Comparison of pyogenic liver abscess caused by non-Klebsiella pneumoniae and Klebsiella pneumoniae.

From January 1996 to April 2002, a total of 248 patients with pyogenic liver abscess were enrolled in this study. Abscesses caused by Klebsiella pneumoniae accounted for 69% (171) of cases. Abscesses caused by K. pneumoniae were more strongly associated with diabetes mellitus or impaired fasting glucose than liver abscesses caused by non-K. pneumoniae (70.2% vs 32.5%). Solitary abscess and monomicrobial isolates were more frequent in the K. pneumoniae group than that in the non-K. pneumoniae group. A total of 42 patients were treated with antibiotics alone. Antibiotics treatment was combined with other procedures, including single aspiration in 23 patients, percutaneous drainage in 176 and surgical drainage in 7. A higher incidence of metastatic infections occurred in the K. pneumoniae group than in the non-K. pneumoniae group (14.6% vs 3.8%). By contrast, the mortality rate of the K. pneumoniae group was lower than that of non-K. pneumoniae group (4.1% vs 20.8%). There was no significant difference in the relapse rate between these 2 groups (6.5% vs 6.4%). We also found that the presence of respiratory symptoms (including cough, dyspnea, or chest distress), size of abscess > or =5 cm in diameter and non-K. pneumoniae pathogens were significant prognostic factors for mortality.

Adolescent↗
PubMed1978

Amoebic liver abscess in Wessex--a retrospective survey of 24 cases.

The clinical features and response to treatment of 24 patients with amoebic liver abscess in Wessex are presented. Two patients died before adequate treatment could be instituted, but 6 of the remaining 22 patients (27%) did not respond to single courses of conventional anti-amoebic therapy. Possible reasons for this high failure rate are discussed. It is concluded that although Metronidazole is a highly effective anti-amoebicide, there remains a place for other drugs such as Emetine. The importance of early diagnosis of Amoebic Liver Abscess is emphasised.

Adult↗
PubMed2004

[Pyogenic liver abscess in chronic alcoholic pancreatitis].

HISTORY AND ADMISSION FINDINGS: A 44-year-old patient was transferred for further treatment of pyogenic liver abscess and a severe attack of a chronic pancreatitis for strong upper right quadrant abdominal pain and recurring fever. INVESTIGATIONS: Laboratory results revealed a significant inflammatory constellation. Abdominal ultrasound was performed which showed a big pyogenic abscess in the right lobe of the liver. Escherichia coli and Enterococcus faecalis could be isolated from abscess aspirates. Endoscopic retrograde cholangiography (ERC) without access of the pancreatic duct showed stenosis of the Ductus hepatocholedochus which was treated with a biliary endoprothesis. DIAGNOSIS, TREATMENT AND COURSE: Antibiotic treatment and percutaneous drainage led to complete remission of the abscess. A few days after discharge the patient returned with identical clinical symptoms. Abdominal ultrasound showed recurrence of the abscess. Because of excessively high pancreatic amylase in aspirated abscess material the patient underwent endoscopic retrograde cholangiopancreaticography (ERCP). There, a pancreatico-hepatic fistula was seen, probably the result of necrosis caused by a severe acute attack of the chronic pancreatitis. After insertion of a naso-fistular drainage, continous rinse and appropriate antibiotic therapy both abscess and fistula completely disappeared without recurrence. CONCLUSION: The rare case of a pancreatic fistula should be considered when a pyogenic liver abscess follows an episode of acute pancreatitis or attack of chronic pancreatitis. Determination of pancreatic amylase in aspired abscess material can be an important step towards correct diagnosis.

Adult↗
PubMed1984

An experimental model for pyogenic liver abscess.

We have developed a reproducible small-animal model for pyogenic liver abscess, suitable for investigating diagnostic and therapeutic modalities. Male New Zealand white rabbits weighing 2-3 kg were anaesthetized and the liver exposed. Gentle pressure was applied with forceps to the right hepatic lobe. A suspension of 10(5) colony forming units (cfu) Escherichia coli plus Fusobacterium necrophorum (10(6) cfu) plus Bacteroides fragilis (10(6) cfu) was immediately injected into a mesenteric vein. Two weeks later a palpable mass (mean diameter 4 cm) had developed. Thick pus could be aspirated percutaneously. Necropsy revealed a single, but often multiloculated, abscess at the site of the previous trauma. Injection of E. coli alone did not produce any abscesses and B. fragilis alone only small abscesses, with low and variable frequency. Inoculation with F. necrophorum alone produced large abscesses, and a dose-response relationship was established. This is a simple and reliable small-animal model useful in studies of imaging techniques, antibiotic regimens and invasive treatments for pyogenic liver abscess.

Animals↗
PubMed1991

Pyogenic liver abscess: a 7-year experience in a large community hospital.

This is a retrospective study of 27 consecutive patients with a diagnosis of pyogenic liver abscess (PLA) seen over a period of 7 years. There were 10 males and 17 females whose ages ranged from 5 to 86 years (mean 56). Fever, abdominal pain and vomiting were the commonest symptoms, and abdominal tenderness was the commonest physical finding. An elevated alkaline phosphatase was seen in 78% of all patients and was the commonest biochemical abnormality. Biliary disease accounted for a third of all cases, and in 22% of the patients the abscesses were considered to be idiopathic. Ultrasonography and/or CT scanning was employed in the diagnosis and follow-up of all patients. Percutaneous needle aspiration (PNA) and percutaneous drainage (PCD) under ultrasound or CT guidance was employed as the primary therapy in 24 patients. The procedure failed in 5 patients (18.5%), there was 1 complication (3.7%) and no deaths were seen as a result of these procedures. Three patients (11%) ultimately died of their abscesses. This study emphasizes the important role of percutaneous drainage as a complementary form of therapy to surgical drainage in the management of pyogenic liver abscesses.

Drainage↗
PubMedDate not supplied

Detection of Entamoeba histolytica using polymerase chain reaction in pus samples from amebic liver abscess.

BACKGROUND AND OBJECTIVE: Direct demonstration of Entamoeba histolytica by conventional microscopy and in vitro culture in pus obtained from amebic liver abscess (ALA) is often unsuccessful. We evaluated polymerase chain reaction (PCR) for detection of E. histolytica DNA in such pus. METHODS: Species-specific primers were used for the amplification of E. histolytica DNA from liver pus obtained from 30 patients with ALA. Patients with pyogenic liver abscess and sterile (autoclaved) pus spiked with Entamoeba dispar and bacteria (Escherichia coli, Klebsiella spp. and Bacteroides spp.) were used as negative controls. RESULTS: PCR was positive in 83% of pus specimens from patients with ALA, and was negative in all 25 pus specimens obtained from pyogenic abscess and autoclaved pus spiked with known bacteria. Sensitivity and specificity of PCR were 83% and 100%, respectively. The overall positivity of PCR was higher compared to serological tests. CONCLUSION: PCR may be a more reliable and better alternative diagnostic modality for ALA.

Animals↗
PubMed1975

New diagnostic and therapeutic techniques in the management of pyogenic liver abscesses.

An unexplained increase in the frequency of pyogenic liver abscesses of unknown etiology has, fourtunately, been paralleled by significant advances in diagnostic and therapeutic methods. This report reviews experience with 14 patients operated upon at NYU Medical Center since 1971. Eight cases (57%) were cryptogenic. Other abscesses were associated with biliary disease (3); abdominal sepsis (2); and trauma (1). Abscesses were present on hospitalization in 12 patients. Clinical findings included fever (101-108 F); 100%; leucocytosis, 71%; anorexia and vomiting, 50%; localized tenderness and hepatomegaly, 50%; hypoalbuminemia, 86%; hypocholesterolemia, 78%; elevated SGOT, 71%; and elevated aikaline phosphatase, 43%. Technetium hepatic scintiscans showed focal defects in 10 of 12 patients (83%), but did not detect multiple abscesses in 2 of these. Hepatic arteriography performed in 10 patients was highly accurate, outlining single abscesses in 6 and multiple abscesses in 4. Furthermore, in one patient a false positive scintiscan was demonstrated by negative arteriography, confirmed by autopsy. In 4 patients, arteriography indicated an abscess in the posterior-superior area of the right hepatic lobe. With precise anatomical localization, a trans-thoracic approach permitted uncomplicated drainage in each case. This approach provides excellent exposure and direct drainage for abscesses in this area. An additional therapeutic adjunct in two patients, with 4 and 11 abscesses each, was postoperative intraportal infusion of antibiotics through the umbilical vein. Thirteen patients (83%) recovered, one dying from pulmonary embolism. Primary hepatic abscesses occur with increasing frequency. Primary hepatic abscesses occur with increasing frequency. Primary hepatic abscesses occur with increasing frequency. The methods described allow more precise preoperative diagnosis and direct surgical drainage.

Adult↗
PubMed1984

Tuberculous liver abscess.

A 36-year-old patient presented with liver abscess, an unusual form of tuberculosis. Her clinical course was a perplexing one since the tuberculosis manifested as prolonged fever from an undefined source. Despite extensive investigations and triple antituberculosis chemotherapy her disease was refractory until surgical drainage was performed.

Adult↗
PubMed1996

[Liver abscess caused by Streptococcus intermedius, following hemorrhoidectomy].

The pyogenic liver abscess is an uncommon but potentially lethal complication of colo-anal surgery. The authors report a case due to Streptococcus intermedius, a pathogen with a known ability to produce visceral abscesses, after haemorrhoidectomy. According to the French consensus conference, the patient had received a prophylactic preoperative antibiotic regimen consisting of metronidazole, active against S intermedius. Despite surgical therapy and adequate antibiotics, the patient died of hepatic failure.

Fatal Outcome↗