Analysis of the Clinical Characteristics of 19 Cases of Bacterial Liver Abscesses in Children and A Review of the Literature

Abstract

Background To analyze the clinical characteristics of 19 children with bacterial liver abscesses and to explore the diagnosis, treatment and prognosis of children with bacterial liver abscesses. Methods Children with bacterial liver abscesses were selected from July 01, 2011, to July 31, 2020, at the Affiliated Children's Hospital of Suzhou University. The onset age, sex, clinical manifestations, imaging and laboratory examination data, treatment and outcomes were analyzed and summarized, and a literature review was performed. Results The average diagnostic age of 19 cases of bacterial liver abscesses was 5 ± 6.7 years old, and the ratio of males to females was 1.7. Ten cases had underlying diseases, including 8 cases of hematological diseases (including leukemia and aplastic anemia) (42.1%), 1 case of a choledochal cyst (5.3%) and 1 case of abdominal trauma (5.3%). The most common clinical manifestations were fever (16 cases, 84.2%), followed by right upper abdominal pain (9 cases, 44.4%) and cough and pleural effusion (6 cases, 31.6% each). Among the laboratory indexes, increases in serum C-reactive protein and leukocytosis were the most common, with 19 cases (100%) and 9 cases (44.4%), respectively. The proportion of patients with abnormal liver function was not high, and there were no cases of elevated bilirubin. The most common pathogens in pus and blood cultures were Klebsiella pneumoniae and Escherichia coli. Nineteen children with bacterial liver abscesses were treated with intravenous antibiotics, and the average duration of intravenous antibiotic use was 28.4 ± 14.7 days. Among the cases, 13 cases (68.4%) were treated with antibiotics alone, and 5 cases (26.3%) and 1 case (5.3%) were treated with percutaneous needle aspiration and surgical drainage, respectively. All 19 children with bacterial liver abscesses improved, and there were no complications or deaths. Conclusion The most common underlying disease was a hematological malignant tumor. Klebsiella pneumoniae and Escherichia coli were the most common pathogens in blood and abscess cultures. Through appropriate antibacterial treatment and timely drainage, the prognosis is usually good.