[Pyogenic hepatic abscess]

Abstract

Ten patients, 6 men and 4 women, with a mean age of 53 years, having pyogenic liver abscess, were studied to review the principal features of the clinical and bacteriological diagnosis. In 9 cases the abscess was located in the right hepatic lobe. Bacteriological diagnosis was made in 6 cases: the etiology was nonmicrobian in 3 and two microorganisms were found in the other 3 cases. The isolated pathogens were: Escherichia coli (3 cases), Staphylococcus sp (3 cases), Enterobacter agglomerans (1 case), Citrobacter sp (1 case), Streptococcus sp (1 case). The basic clinical pattern included fever in 9 patients, pain in upper right side of the abdomen in 8, jaundice in 5 and respiratory symptoms in 5. In 2 cases the diagnosis was confirmed by ultrasonography, in 2 by scintigraphy and in 3 both methods were used. Surgical drainage was practiced in 7 patients, with favorable course in 6. Three patients were not operated; 2 died and the third was cured with medical treatment. The importance of the clinical suspicion even with few data is pointed out, specially prolonged fever with painful syndrome in upper right side of the abdomen. The aid of the diagnosis imaging is valuable for verification. The precise bacteriological diagnosis by culture of the material obtained in surgery or by percutaneous drainage of the abscess allows the selection of the most suitable antibiotic therapy.