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At least 991 records · Page 55Linked to original sources
PubMed2002

Pyogenic liver abscess -- 20 years' experience. Comparison of results of treatment in two periods.

BACKGROUND AND AIMS: Our aim is to give an audit of our experience over the past two decades in the form of a retrospective study. PATIENTS/METHODS: In two equal periods between 01.01.1982 and 31.03.2001, 56 patients (37 males and 19 females) with pyogenic liver abscess were treated. Image-guided percutaneous drainage was performed in 22.2%/20.6% of the patients; the remainder were treated with open drainage with or without biliary tract reconstruction and liver resection. For antibiotic perfusion of the liver an umbilical vein cannula was inserted in 40.7%/24.1%. Microbiological findings, types of therapy, complications and mortality, etiology, patient characteristics, symptoms, and laboratory data were investigated. The results in the two groups were compared and analyzed statistically. RESULTS: The most common cause of abscess, biliary disease, was seen more often in the second period. Solitary liver abscesses were more frequent. The only characteristic biochemical finding was an elevated alkaline phosphatase level. There were more positive cultures in the second period (70.4%/79.3%), and the number of Escherichia coli or Enterobacter aerogenes infections also increased. In the first period the mortality was 18.5%, whereas in the second no patients were lost. CONCLUSION: We suggest the importance of individualized therapy based on an early and exact diagnosis. The first treatment step should be image-guided drainage, but under well-defined circumstances open drainage can also be performed with good results.

Adult↗
PubMed2001

A member of the delta subgroup of proteobacteria from a pyogenic liver abscess is a typical sulfate reducer of the genus Desulfovibrio.

Strain FH26001/95 (ATCC 700045) was previously isolated from a pyogenic liver abscess from a human. Comparative 16S rRNA gene sequence analysis showed that this strain is related to members of the delta subgroup of the proteobacteria, within a cluster of sulfate-reducing bacteria (Desulfovibrio spp.) and non-sulfate-reducing bacteria (Bilophila wadsworthia and Lawsonia spp.). The phenotype of strain FH26001/95 was found to be typical of members of the genus Desulfovibrio. Growth and substrate transformations were possible at oxygen concentrations of 2 to 5% (vol/vol) but not at oxygen concentrations of 21% (vol/vol) in air. Its isolation from an infection in a human suggests that some members of the genus Desulfovibrio can be considered opportunistic pathogens.

Aerobiosis↗
PubMed1979

Amebic liver abscess. Report of a case presenting with nonreactive serologic tests for Entamoeba histolytica.

We present a patient with an acute amebic liver abscess with nonreactive serologic tests. Motile hematophagous trophozoites of Entamoeba histolytica were seen microscopically in scrapings from the wall of the abscess. Postoperative serologies revealed rapidly rising then falling titers by SAFA and IHA antibody assays. Serologic tests for amebiasis may be reative in greater than 95% of patients with invasive amebiasis. Nevertheless, a reactive serologic test should not be relied upon exclusively to establish the diagnosis. Sequential serologic testing and surgical intervention to obtain material for microscopic examination, gram stain and bacteriologic culture are warranted in patients with hepatic abscess and nonreactive serologic tests for antibodies to E. histolytica.

Adult↗
PubMedDate not supplied

Solitary pyogenic liver abscess: a statistical analysis of 117 cases.

In this study, we present 117 cases of solitary pyogenic liver abscess. The average age was 30, and the most important clinical findings were pain (81.8%), chills and fever (52.2%) and hepatomegaly (64.1%). The laboratory findings were as follows: leukocytosis (61.4%), elevated sedimentation rate (71.6%), BUN over 50 mgs (15.3%), average SGOT: 20.1, SGPT: 20.3, and alkaline phosphatase: 82.6 mU. X-ray examination revealed pathological findings in the right pleural cavity and diaphragm in 61.5% of cases. Radioisotope scanning of the liver was helpful in 88.5% of cases. The preoperative diagnosis was correct in 72%. The abscess was located in the right lobe in 83.8%, in the left lobe in 14.5%, and in both lobes in 1.7%. The average abscess volume was 500 cc, and the pus was sterile in 77.7%. The overall complication rate was 31.6%, and the mortality rate was 17.9%. The patients were treated by early systematic surgical drainage.

Adolescent↗
PubMed1979

Occult liver abscess and foreign body perforation of the bowel.

A unique case of foreign body perforation of the ileum and large occult liver abscess is reported. Preoperative abdominal ultrasonography localized the abscess cavities, permitting successful drainage and eventual full recovery of the patient. Due to the serious morbidity and mortality associated with undrained hepatic abscess, the possibility of this complication should be remembered in all patients with localized inflammatory conditions of the abdomen, particularly when hepatic dysfunction is unexplained.

Aged↗
PubMed1994

Liver abscess following blunt trauma: a case report and review of the literature.

We report a case of Haemophilus paraphrophilus causing primary liver abscesses after blunt nonpenetrating trauma. A 32-year-old previously healthy white man sustained a back injury 2 months prior to admission with fever, chills, and night sweats. A computed tomography (CT) scan-directed needle aspirate of several hypoechoic hepatic lesions grew H paraphrophilus. Recent blunt trauma to the lower back may have contributed to the localization of this infection to an area of contusion or hematoma within the liver, followed by an episode of bacteremia that seeded the injury.

Adult↗
PubMed2002

Effect of intracavitary injection of urokinase in the experimentally induced early pyogenic liver abscess of the rabbit.

This study was carried out to assess the effects of intracavitary injection of urokinase in the early liver abscess (ELA) of the rabbits. ELAs were induced on 25 in 47 New Zealand rabbits, which were divided into two groups, with 15 in group A, and 10 in group B. Urokinase was injected into the ELA of group A, and normal physiologic saline into those of group B. One and a half hours after the injections, the rabbits were sacrificed and evaluated by pathologists for the degree of fibrosis of the ELA wall, and fibrinolysis in the ELA itself. Statistical analyses were performed between the two groups. The following ELA sizes for each group were obtained: Group A, 4.3 x 2.9-10.1 x 7.2 mm (mean 7.1 x 4.1 mm); Group B, 4.6 x 2.7-15.0 x 9.7 mm (mean 8.5 x 4.57 mm). Eleven (73%) in group A showed grade II fibrosis of ELA wall, and 8 (80%) in group B showed grade III fibrosis of ELA wall (p=0.002). On pathological analysis, 5 (46%) in group A showed grade II fibrin, and 8 (80%) in group B showed grade III fibrin, of the ELA (p=0.09). In conclusion, injection of urokinase, into the ELAs, can reduce the degree of fibrosis of abscess walls.

Animals↗
PubMed2005

[Amoebic liver abscess--case report].

The authors present a case of a young male, who suffered with extraintestinal form of amoebiasis-amoebic liver abscesses. The patient traveled to India two month before symptoms onset. The diagnosis based on ultrasonography and computed tomography was definetely confirmed by serological examination. Metronidazol treatment was given initially, followed by percutaneous drainage. Open surgical tretment was indicated due to failure of percutaneous treatment. Patient was discharged home in a good condition one month after surgery. At this time patient is doing well eight months after surgery.

Adult↗
PubMed1988

Echo-guided percutaneous puncture: a safe and valuable therapeutic tool for amebic liver abscess.

To clarify the therapeutic role of echo-guided percutaneous puncture (EPP) in management of amebic liver abscess, 20 patients (24 abscesses) received metronidazole plus EPP. Fluid was aspirated through Chiba needles under real-time sonographic guidance so as to reduce cavity size to less than 3 cm. Not more than two EPPs were necessary in the majority of cases and no complication followed the procedure. This scheme resulted in a shortening of time of both hospitalization (less than or equal to 20 days) and liver lesion healing as assessed by ultrasound (less than or equal to 4 months). It is concluded that EPP is a valuable and safe therapeutic tool for hepatic amebic abscess.

Adult↗
PubMedDate not supplied

Coccidioidomycosis presenting as liver abscess.

A 26-year-old man presented with pain in the right upper abdomen. Ultrasonography revealed a large solitary right lobe liver abscess, which was treated by aspiration and antiamebic treatment. The patient continued to be symptomatic with the abscess increasing in size. Repeat aspiration revealed a pure growth of coccidioidomycosis, which was confirmed on culture. He was treated with amphotericin-B; the abscess resolved completely and the patient has remained asymptomatic at one-year follow up.

Adult↗
PubMed2005

Multiple spleen and liver abscesses due to Yersinia enterocolitica septicemia in a child with congenital sideroblastic anemia.

In patients with iron overload, opportunistic infections are an underestimated risk. Yersinia enterocolitica is a rare organism to be isolated in this setting. The authors report a case of disseminated Y. enterocolitica sepsis in a 5-year-old boy with sideroblastic anemia. Ultrasound examination revealed massive ascites, a pseudo-appendicitis, and hypoechogenic lesions corresponding to abscess formations in the liver and spleen. The initial antibiotic therapy consisted of cefotaxime, gentamicin, and metronidazole, but only treatment with ciprofloxacin and meropenem led to defervescence and clinical stabilization. The risk of developing uncommon infections in patients with iron overload should be acknowledged by all physicians, and the relevance of ultrasound examination is emphasized. In this case, only a detailed history revealed that several days before the onset of diarrhea, the child was feeding a deer; this is how infection was probably acquired.

Anemia, Sideroblastic↗