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Pyogenic liver abscess: retrospective analysis of 80 cases over a 10-year period
Wai-Man Wong1, Benjamin Chun Yu Wong, Chee Kin Hui
1University Department of Medicine, Queen Mary Hospital, University of Hong Kong, China. wmwongg@hku.hk
Background:
A total of 80 patients with pyogenic liver abscess managed at a single institution over a 10-year period were studied.
Methods:
The clinical features, laboratory, imaging, and microbiologic findings, management strategy, and final outcome were studied.
Results:
Fever and chills, leucocytosis and elevated alkaline phosphatase were the most common clinical and laboratory findings. Forty-one percent of patients were diabetic and 61% had biliary pathology. Systemic antibiotics and image-guided aspiration had a success rate of 94%. By multiple logistic regression analysis, malignancy on presentation (P = 0.011) was an independent risk factor associated with mortality. A past history of endoscopic sphincterotomy was an independent factor associated with resolution of liver abscess within 6 weeks (P = 0.03).
Conclusion:
Pyrexia, leucocytosis, elevated alkaline phosphatase, presence of diabetes, and underlying biliary pathology are common clinical and laboratory findings in patients with pyogenic liver abscess. Malignancy was associated with a poor outcome. Previous endoscopic sphincterotomy was a good prognostic factor for early resolution.