Pyogenic Liver Abscesses in Children

Arya, L. S.; Ghani, Rashid; Abdali, Selli; Singh, Meharban

doi:10.1177/000992288202100204

Cited by 19 publications

(12 citation statements)

References 20 publications

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“…Liver abscess A total of 120 cases of pyogenic nonanaerobic bacterial hepatic abscess in childhood were reported (3,26,48). The microorganisms commonly recovered include Staphylococcus aureus, E. coli, Enterococcus faecalis, Klebsiella spp., Enterobacter spp., Pseudomonas organisms, and salmonellae.…”

Section: Intra-abdominal Abscessmentioning

confidence: 99%

Intra-Abdominal, Retroperitoneal, and Visceral Abscesses in Children

Brook

2004

Eur J Pediatr Surg

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This review describes the microbiology, diagnosis, and management of intra-abdominal abscesses (including subphrenic, hepatic, splenic, and retroperitoneal abscesses) in children. They often occur as a complication of local or generalized peritonitis, commonly secondary to appendicitis, necrotizing enterocolitis, pelvic inflammatory disease, and tubo-ovarian infection, surgery or trauma. The original infection generally occurs because of the entry of enteric microorganisms into the peritoneal cavity through a defect in the wall of the intestine or other viscus as a result of obstruction, infarction, or direct trauma. Mixed aerobic and anaerobic flora can be recovered from most abscesses. The predominant aerobic isolates are Escherichia coli, Staphylococcus aureus, and Enterococcus spp. and the main anaerobic bacteria are Bacteroides fragilis group Peptostreptococcus spp., Fusobacterium spp., and Clostridium spp. The treatment of intraabdominal abscesses includes drainage, surgical correction of pathology, and administration of antimicrobials effective against both aerobic and anaerobic microorganisms.

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Section: Intra-abdominal Abscessmentioning

confidence: 99%

Intra-Abdominal, Retroperitoneal, and Visceral Abscesses in Children

Brook

2004

Eur J Pediatr Surg

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“…The microbiological species most often associated with liver abscesses in pediatric patients include Staphylococcus aureus, Escherichia coli, Klebsiella species, Enterobacter species, and Pseudomonas species (1,2). Anaerobes rarely account for these infections.…”

mentioning

confidence: 99%

“…Treatment for these frequently polymicrobial liver abscesses must include early antimicrobial coverage in addition to surgical drainage and debridement (1,7). Cefoxitin alone will not adequately cover all anaerobes since about 35% of Clostridiuin species are reported to be cefoxitin resistant (6).…”

mentioning

confidence: 99%

Liver abscess caused by Clostridium bifermentans following blunt abdominal trauma

Nachman

Kaul

et al. 1989

J Clin Microbiol

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“…Till date, most studies have shown Staphylococcus aureus as the commonest causative agent of PLA followed by Gram-negative organisms. 3,5,21,22 In our study, we encountered a higher prevalence of Gram-negative bacteria. This is in concordance with 3 other Taiwanese studies which reported the dominance of K. pneumonia followed by E Coli.…”

Section: Discussionmentioning

confidence: 61%

Pediatric Liver Abscess: Outcomes of Protocol-based Management and Predictors of Poor Outcome

Anand

Sahi

Mandal

2023

Pediatric Infectious Disease Journal

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Background: Liver abscess (LA) is an important cause of morbidity in children, especially in tropical countries. There is a paucity of data in pediatric LA with no standard guidelines regarding the best modality of treatment and drainage. With a large influx of patients at our center and protocol-based management; we aimed to study clinic-radiologic profile, risk factors, complications and outcomes of children with liver abscess and assessed possible predictors for poor outcomes. Materials and methods: This retrospective observational study was conducted from January 2019 to September 2019 at a tertiary care hospital in India. Records of all children (<12 years of age) with ultrasonographically diagnosed liver abscess were accessed for clinic-radiological and demographic profile, laboratory investigations, treatment, complications and outcomes. Patients were categorized into favorable or unfavorable groups based on predefined criteria and were compared for possible predictors of poor outcomes. Outcomes for the protocol-based management were analyzed. Results: There were 120 cases of pediatric liver abscess with a median age of 5 years at presentation. The commonest clinical features were fever (100%) and pain in the abdomen (89.16%). The majority of liver abscesses were solitary (78.4%) and in the right lobe (73.3%). Malnutrition was present in 27.5%, overcrowding for 76.5% of patients and worm infestation in 2.5% of patients. Age-related leukocytosis (P = 0.004), neutrophilia (P = 0.013), elevated Aspartate transaminase (P = 0.008), elevated alanine transaminase (P = 0.007) and hypoalbuminemia (P = 0.014) were significantly more in the unfavorable group. Overall, 29.2% of patients underwent conservative management with antibiotics alone, 25.0% underwent percutaneous needle aspiration (PNA), 49.1% underwent ultrasound-guided percutaneous drain (PCD) insertion and open surgical drainage (OSD) was needed in a single patient. The success rate was 100% for conservative management, 76.6% for PNA, 94.7% for PCD and 100% for OSD with an overall mortality of 2.5%. Conclusions: Age-related leukocytosis, neutrophilia, elevated aspartate transaminase or alanine transaminase and hypoalbuminemia at presentation are predictors of poor outcomes in pediatric liver abscess. Protocol-based management leads to the appropriate use of PNA and PCD while decreasing mortality and morbidity related to either.

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Pyogenic Liver Abscesses in Children

Cited by 19 publications

References 20 publications

Intra-Abdominal, Retroperitoneal, and Visceral Abscesses in Children

Intra-Abdominal, Retroperitoneal, and Visceral Abscesses in Children

Liver abscess caused by Clostridium bifermentans following blunt abdominal trauma

Pediatric Liver Abscess: Outcomes of Protocol-based Management and Predictors of Poor Outcome

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