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Neonatal hepatic abscess in preterm infants:a rare entity?
N W H Tan1, B Sriram, A P A Tan-Kendrick
1Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore. nataliewhtan@yahoo.com
Annals of the Academy of Medicine, Singapore
|November 15, 2005
Summary
Neonatal pyogenic liver abscess is rare in preterm infants. Early diagnosis with hepatobiliary ultrasound and prompt treatment are crucial for a good outcome, though sepsis remains a risk.
Area of Science:
- Neonatology
- Pediatric Surgery
- Infectious Diseases
Background:
- Neonatal pyogenic hepatic abscess is an uncommon condition in premature infants.
- This study reviews six cases to improve understanding and management.
Purpose of the Study:
- To present a series of neonatal liver abscess cases.
- To outline an approach for early diagnosis and management.
- To review the literature on this rare condition.
Main Methods:
- Retrospective case record review of six patients diagnosed between January 2000 and December 2002.
- Analysis of clinical data, treatment, and outcomes.
Main Results:
- All infants were preterm (24-34 weeks gestation).
- Hepatobiliary ultrasound was key in diagnosis, especially with persistent positive blood cultures.
- Treatment included surgical drainage (33%) or conservative antibiotic management.
- Outcomes were dichotomous: 50% recovered, 50% died from sepsis.
Conclusions:
- Prompt diagnosis and treatment of neonatal pyogenic liver abscess are associated with favorable outcomes.
- A high index of suspicion is needed for preterm infants with sepsis and persistent positive blood cultures.
- Hepatobiliary ultrasound is essential for detection and monitoring.