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Pyogenic liver abscess.

G B Zibari1, S Maguire, D F Aultman

  • 1Department of Surgery, Louisian State University Medical Center, Shreveport, LA 71130-3932, USA. gzibari@LSUMC.edu

Surgical Infections
|February 22, 2003
PubMed
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Pyogenic liver abscesses are often caused by gram-negative bacteria and commonly affect the right liver lobe. Percutaneous drainage guided by CT or ultrasound is a safe and effective treatment for these abscesses.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Radiology

Background:

  • Pyogenic liver abscess (PLA) is a significant condition requiring updated understanding of its pathogenesis, diagnosis, and treatment.
  • While amebic liver abscesses are more common globally, PLA predominates in the United States.
  • This study focuses on PLA, evaluating its etiology, management, morbidity, and mortality.

Purpose of the Study:

  • To evaluate the etiology, management, morbidity, and mortality of patients diagnosed with pyogenic liver abscess.
  • To assess the effectiveness and safety of diagnostic and treatment modalities for PLA.

Main Methods:

  • Retrospective chart review of patients admitted with pyogenic liver abscess between 1983 and 1996.
  • Analysis of patient demographics, presenting symptoms, physical findings, etiologies, abscess characteristics, and treatment outcomes.

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Main Results:

  • Twenty patients with PLA were identified; the average age was 52, with males and African-Americans predominating.
  • Common symptoms included fever and pain; right upper-quadrant tenderness was the most frequent finding.
  • Cryptogenic, trauma, and biliary causes were most common etiologies; 95% involved the right liver lobe, and 70% were solitary.
  • Computed tomography (CT) and ultrasound-guided percutaneous drainage were used in 85% of cases.
  • Gram-negative organisms were most common (50%), with 60% of positive cultures being polymicrobial.
  • No in-house mortality was observed.

Conclusions:

  • CT and ultrasound-guided percutaneous drainage are safe and effective treatments for pyogenic liver abscesses.
  • The right lobe is the most common site of involvement.
  • Gram-negative bacteria are the predominant organisms, often in polymicrobial infections.