Morphological Characteristics of Liver Abscesses According its Etiology

Castillo, Sergio; Manterola, Carlos

doi:10.4067/s0717-95022020000200406

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…Several studies are also in coherence with this fact. [ 5 10 ] We also found oxidase-positive bacteria like Elizabethkingea meningosepticum (9%) and Cupriavidus pauculus (3%), which we did not find in any literature . Elizabethkingea meningosepticum is an opportunistic pathogen which is predisposed by diabetes mellitus, steroid use, organ transplantation, neutropenia, prolonged hospitalization, prior administration of multiple antibiotics, and chronic hemodialysis.…”

Section: Discussioncontrasting

confidence: 49%

“…The sensitivity of ultrasonography and CT scan is reported 80%–95% and 95%–98%, respectively. [ 5 ] But, ultrasonography is cheaper; hence, it is more commonly used for diagnosis . [ 1 ] On imaging techniques, PLA is found as a solitary abscess in 65%–85% of cases having more affinity for right lobe of liver.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] There are various poor prognostic factors like progression of sepsis, multiple abscesses, polymicrobial infection, antibiotic-resistant pathogens, age more than 70 years, abscess associated with neoplasia, and immunosuppression. [ 5 ] PLA presents through nonspecific symptoms like fever, abdominal pain, vomiting making diagnostic difficulty for clinicians. Hence, diagnosis of PLA often requires a combination of clinical features, imaging techniques like ultrasonography or CT scan, and microbiological findings.…”

Section: Introductionmentioning

confidence: 99%

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Pyogenic liver abscess: Clinical features and microbiological profiles in tertiary care center

Kumar¹,

Perween

Omar

et al. 2020

J Family Med Prim Care

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Background: Pyogenic liver abscess (PLA) is the end result of a number of pathologic processes that cause a suppurative infection of the liver parenchyma. Materials and Methods: Sixty-five patients of age more than 18 years and radiologically confirmed cases of liver abscess were included in this study. Pus and blood samples were collected. Pus was processed for microscopy of trophozoite of Entamoeba histolytica and aerobic and anaerobic bacterial culture. Blood was processed for antibody ELISA for Entamoeba histolytica and aerobic bacterial culture. Identification of aerobic and anaerobic isolates was done by Vitek2 and antibiotic sensitivity test for aerobic bacterial isolates was done by Vitek2. Result: Out of sixty five, twenty five were confirmed as PLA. All patients were male with mean age 37.9 years. Fever and upper abdominal pain were the most common symptoms. Right lobe comprised 80% of the abscess. Pus sample was more sensitive than blood sample for diagnosis. There were a total of 33 isolates in our study. Klebsiella pneumoniae (6/33) was the most common aerobic isolate and Clostridium spp. (7/33) was the anaerobic isolate. All gram-negative bacteria were showing good sensitivity for 3 rd and 4 th generation cephalosporins, fluoroquinolones, amikacin, gentamicin, piperacillin-tazobactam, imipenem and meropenem. Abscess >5 cm was treated with percutaneous drainage while abscess <5 cm was treated with antibiotics only. Conclusion: Diagnosis should be made with the combination of clinical suspicion, radiology, and microbiology. Empirical therapy should include anaerobic coverage too. Only antibiotic therapy can be given under consideration of size of abscess, persistence of fever after giving antibiotics, and any suspected complications.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pyogenic liver abscess: Clinical features and microbiological profiles in tertiary care center

Kumar¹,

Perween

Omar

et al. 2020

J Family Med Prim Care

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“…A PLA is a life-threatening infection with an incidence ranging from 8-22 per 1,000,000 people depending on different geographical areas [4]. There are various poor prognostic factors like the progression of sepsis, multiple abscesses, polymicrobial infection, antibiotic-resistant pathogens, age more than 70 years, abscess associated with neoplasia, and immunosuppression [5,6] The presentation of an LA is often nonspecific, including fever, abdominal pain, and vomiting, creating a diagnostic quandary; thus, the diagnosis is established based on clinical features and imaging, including an ultrasound or CT scan of the abdomen. Imaging modalities are useful for determining the location and size of the lesion, and image-guided aspiration is critical for determining the type of microbial responsible and its medical treatment [7].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Clinical Features, and Outcome of Liver Abscess: A Single-Center Experience

Sahu¹,

Pipal²,

Singh³

et al. 2022

Cureus

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IntroductionLiver abscesses are rare, but whenever they occur, it is predominantly among males over 60 years of age. The paradigm in the treatment has changed, and percutaneous drainage is now the initial treatment for drainage of the abscesses. Open surgery is reserved for patients with septated abscesses and those greater than 5 cm. ObjectiveTo study the etiological, clinical, pathological, and demographic characteristics of individuals with liver abscesses and to evaluate the outcome associated with different treatment strategies. MethodsThis clinico-epidemiological study was carried out at a tertiary care hospital in Jodhpur. One hundred patients with liver abscesses were studied. Patients were assigned to three groups: Group 1 -medical management alone (in non-aspirable uncomplicated abscess), Group 2 -USG-guided needle aspiration or pigtail percutaneous catheter drainage plus medical management (in unruptured aspirable abscess), Group 3 -open surgical drainage plus medical management (In ruptured abscesses). Of the total patients, 36% were treated with medical therapy alone, 45% with USG-guided needle aspiration, 10% with USG-guided percutaneous catheter drainage, and 9% with open surgical drainage. ResultsIn our study, fever and hepatomegaly were the commonest presentations, observed in 91% and 62% of cases, respectively. Escherichia coli (E.coli) was the predominant organism cultured in 28 (43.75%) patients followed by Klebsiella growing in 24 (37.50%) patients. The right lobe was affected more (83%) than the left lobe and in the majority (83%), a solitary abscess was present. The mean age of liver abscess presentation was 40.72 years, with a 5.67:1 male-to-female ratio. Alcohol consumption was reported by 33% of patients, the majority of whom were men. Serum bilirubin was elevated in 56% of liver abscess patients, while it was normal in 44%. The mean serum bilirubin was 2.08 mg/dl. The mean value in group 1, group 2, and group 3 was 1.44 mg/dl, 2.23 mg/dl, and 2.57 mg/dl, respectively. Liver abscesses were identified in 76% of patients with right lobes; 83% had solitary liver abscesses and 17% had numerous abscesses. Abscess culture showed E. coli in 21 (32.81%) and Klebsiella in 17 (26.56%) patients. ConclusionRight-sided solitary pyogenic liver abscess caused by E.coli is the most common liver abscess, with fever and hepatomegaly as the most common presentation. Non-aspirable liver abscesses, regardless of aetiology, can be successfully treated by medical therapy alone. Needle aspiration or catheter drainage is standard for liver abscesses. Thus, needle aspiration has replaced the surgical exploration of liver abscesses.

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Infected hepatic echinococcosis. Clinical, therapeutic, and prognostic aspects. A systematic review

Castillo

Manterola

Grande

et al. 2021

Annals of Hepatology

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Morphological Characteristics of Liver Abscesses According its Etiology

Cited by 3 publications

References 16 publications

Pyogenic liver abscess: Clinical features and microbiological profiles in tertiary care center

Pyogenic liver abscess: Clinical features and microbiological profiles in tertiary care center

Epidemiology, Clinical Features, and Outcome of Liver Abscess: A Single-Center Experience

Infected hepatic echinococcosis. Clinical, therapeutic, and prognostic aspects. A systematic review

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