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PubMed1990

Circulating E. histolytica antigens clear with successful treatment of amoebic liver abscess.

An antigen capture ELISA was used to measure serum E. histolytica antigen and antibody levels in 23 patients with amebic liver abscess (ALA), 15 patients with intestinal amebic infections (IAI), and 20 normal controls. 16 of the 23 (70%) with ALA had antigenemia. None of those with IAI or the normal controls had E. histolytica antigen titers of greater than 1:4. All 23 of the patients with ALA had positive antibody titers. Three (20%) with IAI and none of the normal controls had E. histolytica antibody titers greater than 1:100. Antigenemia cleared in all but one of the 23 patients within two months of initiating successful chemotherapy. Antibody titers were much slower to diminish. Measuring E. histolytica antigens in the sera of patients with ALA by increasing the diagnostic specificity may have some diagnostic advantage over measuring only the antibody levels. In addition, serial measurements of antigenemia are useful in monitoring result following chemotherapy.

Animals↗
PubMed1987

Pyogenic liver abscess. Diagnostic and therapeutic strategies.

A retrospective review of 26 adult patients admitted to University of California, Davis, Medical Center (UCDMC) with pyogenic liver abscess (1980-1986) was performed to ascertain the impact of rapid diagnosis and percutaneous drainage. Ultrasonographic examinations and computed tomography (CT) scans were highly sensitive and noninvasive imaging modalities. Sixteen patients had solitary abscesses and seven had multiple microscopic abscesses. The median time interval from admission to diagnosis and therapy was 2 and 3 days, respectively. Origin of the abscess was determined in 22 patients, the biliary tree being the most common source. Medical therapy was successful in three patients with microabscesses but failed in two. Nine patients had percutaneous drainage; two required repetitive percutaneous catheter placement, and two proceeded to surgical drainage. Twelve patients had surgical drainage; one required repetitive surgical drainage. Postdrainage complications were minimal in all groups. Overall mortality role was 11.5% (two patients). Deaths were related to delay in diagnosis, gram-negative sepsis at presentation, and biliary origin of the abscess.

Adult↗
PubMed1999

[Diagnostic imaging and interventional radiology of amebic liver abscesses. Personal experience].

PURPOSE: The diagnostic imaging findings in hepatic amebiasis and the capabilities of percutaneous drainage have already been described but some debate is open on both diagnosis and treatment. We report our experience with ultrasound (US) and Computed Tomography (CT) studies of the hepatic amebic abscess and its management. MATERIAL AND METHODS: During the last 4 years we examined 14 patients with liver abscess: 11 men and 2 women; 13 were Italian and 1 African (25-61 years old, mean 36). All subjects underwent US and contrast-enhanced CT (with a conventional scanner in 12 and a helical unit in 2). The first 4 cases were also submitted to US-guided diagnostic aspiration. Six patients were treated with percutaneous drainage under US guidance using an 8-10 F pig-tail catheter which was removed 4-18 days later (mean 6). RESULTS: The abscesses were always single and uniloculated, in most cases located peripherally in the right lobe. They were large (2-11 cm, mean 7) and had round, oval, or irregular shape in 9, 3, and 2 cases respectively. US generally showed the abscess as an inhomogeneously hypoechoic mass with ill-defined walls. CT demonstrated a homogeneously hypodense collection with a thick peripheral hypodense halo; after contrast agent administration wall attenuation was increased between the edematous halo and the cavity, and an incomplete idosense ring appeared. Biphasic helical acquisitions allowed demonstration of some difference between the two vascular phases and yielded other interesting findings. Drug treatment provided complete abscess resolution in 8 patients, though in 2 it was badly tolerated. In one case no improvement was found and the patient was submitted to percutaneous drainage, which was the treatment of choice in the remaining 5 patients. The treatment was successful in all cases, but 1 patient who discontinued the combined medical therapy developed a heterotopic lesion. CONCLUSION: US and CT findings, though variable and partially different from those previously reported, may be considered sufficient for diagnostic assessment, especially if in the proper clinical and biohumoral setting. Both drug treatment and percutaneous drainage (to be considered for selected cases) are effective in the treatment of this type of abscess.

Adult↗
PubMedDate not supplied

Streptococcus milleri: a cause of pyogenic liver abscess.

We report a case of Streptococcus milleri in a patient with a history of hypertension, alcohol abuse, and tobacco smoking. S. milleri is associated with liver abscesses much more frequently than other streptococci.

Humans↗
PubMed1994

Chest complications of amoebic liver abscess: a report of six cases from Nigeria.

During a seven year period, six patients with intra-thoracic rupture of amoebic liver abscesses required surgical intervention. Of the six cases, three ruptured into the right pleural space, two into the right lower lobe and one into the pericardium. Definitive surgical procedures performed were decortication and repair of the diaphragm in three, segmental lung resection and repair of the diaphragm in two cases and continuous subxyphoid catheter drainage of the pericardium in the remaining case. There were no death and the morbidity was insignificant.

Adolescent↗
PubMed1989

Complicated appendiceal inflammatory disease in children: pylephlebitis and liver abscess.

Five children with complicated appendiceal inflammatory disease are reported. They presented with nonspecific signs and symptoms, but three had liver abscess and two had inflammation of the portal vein. The inflamed portal vein may act as a conduit to the liver for bacteria, or it may become thrombosed and cause portal hypertension and hypersplenism. In one child, symptomatic portal hypertension developed 10 years after the initial disease. In children, an ultrasonic finding of a focal liver mass of low-to-mixed echogenicity or the presence of low-attenuation areas on computed tomographic scans should suggest the possibility of a hepatic abscess, and the radiologist has a major role in suggesting complicated inflammatory disease of the appendix as the cause. Similarly, when portal vein thrombosis or portal hypertension are found, the radiologist should consider complicated inflammatory disease of the appendix as the cause.

Adolescent↗
PubMedDate not supplied

Bacterial-mycotic liver abscess in a non-immunocompromised host.

We are presenting the case of a 70-year-old, formerly healthy patient. Seven weeks after abdominal surgery, a liver abscess was diagnosed by sonography and aspiration. Cultures revealed a mixed bacterial-fungal etiology. Treatment with irrigation (povidone iodine) and parenteral mezlocillin failed. Final cure was only achieved when long-term treatment with piperacillin and miconazole was initiated and abscess drainage removed.

Aged↗
PubMed1988

Primary tuberculous liver abscess associated with the human immunodeficiency virus.

Extrapulmonary tuberculosis has been noted to occur frequently in patients with the Acquired Immunodeficiency Syndrome (AIDS). Tuberculous liver abscesses are rare. The following case report describes a patient with Human Immunodeficiency Virus (HIV) antibody who exemplifies this unusual manifestation of mycobacterial infection.

Adult↗