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. 2011 Mar 28;17(12):1622-30.
doi: 10.3748/wjg.v17.i12.1622.

Pyogenic liver abscess: an audit of 10 years' experience

Tony C Y Pang  1 , Thomas Fung, Jaswinder Samra, Thomas J Hugh, Ross C Smith
Affiliations

Pyogenic liver abscess: an audit of 10 years' experience

Tony C Y Pang et al. World J Gastroenterol. .

Abstract

Aim: To describe our own experience with pyogenic liver abscesses over the past 10 years and investigate the risk factors associated with failure of initial percutaneous therapy.

Methods: A retrospective study of records of 63 PLA patients presenting between 1998 and 2008 to Australian tertiary referral centre, were reviewed. Amoebic and hydatid abscesses were excluded. Demographic, clinical, radiological, and microbiological characteristics, as well as surgical/radiological interventions, were recorded.

Results: Sixty-three patients (42 males, 21 females) aged 65 (± 14) years [mean ± (SD)] had prodromal symptoms for a median (interquartile range; IQR) of 7 (5-14) d. Only 59% of patients were febrile at presentation; however, the serum C-reactive protein was elevated in all 47 in whom it was measured. Liver function tests were non-specifically abnormal. 67% of patients had a solitary abscess, while 32% had > 3 abscesses with a median (IQR) diameter of 6.3 (4-9) cm. Causative organisms were: Streptococcus milleri 25%, Klebsiella pneumoniae 21%, and Escherichia coli 16%. A presumptive cryptogenic cause was most common (34%). Four patients died in this series: one from sepsis, two from advanced cancer, and one from acute myocardial infarction. The initial procedure was radiological aspiration ± drainage in 54 and surgery in two patients. 17% underwent surgical management during their hospitalization. Serum hypoalbuminaemia [mean (95% CI): 32 (29-35) g/L vs 28 (25-31) g/L, P = 0.045] on presentation was found to be the only factor related to failure of initial percutaneous therapy on univariate analysis.

Conclusion: PLA is a diagnostic challenge, because the presentation of this condition is non-specific. Intravenous antibiotics and radiological drainage in the first instance allows resolution of most PLAs; However, a small proportion of patients still require surgical drainage.

Keywords: C-reactive protein; Hypoalbuminaemia; Image guided drainage; Pyogenic liver abscess; Surgical drainage.

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References

    1. Johannsen EC, Sifri CD, Madoff LC. Pyogenic liver abscesses. Infect Dis Clin North Am. 2000;14:547–563, vii. - PubMed
    1. Wong WM, Wong BC, Hui CK, Ng M, Lai KC, Tso WK, Lam SK, Lai CL. Pyogenic liver abscess: retrospective analysis of 80 cases over a 10-year period. J Gastroenterol Hepatol. 2002;17:1001–1007. - PubMed
    1. Rintoul R, O'Riordain MG, Laurenson IF, Crosbie JL, Allan PL, Garden OJ. Changing management of pyogenic liver abscess. Br J Surg. 1996;83:1215–1218. - PubMed
    1. Barakate MS, Stephen MS, Waugh RC, Gallagher PJ, Solomon MJ, Storey DW, Sheldon DM. Pyogenic liver abscess: a review of 10 years' experience in management. Aust N Z J Surg. 1999;69:205–209. - PubMed
    1. Lee KT, Wong SR, Sheen PC. Pyogenic liver abscess: an audit of 10 years' experience and analysis of risk factors. Dig Surg. 2001;18:459–465; discussion 465-466. - PubMed

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