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[Hepatic abscess in children: analysis of 20 cases]
C E de Kolster1, N Guerreiro, L de Escalona
1Departamento de Pediatría y Radiología, Universidad de Carabobo.
Insights
This study analyzed pediatric liver abscesses, finding amebic and pyogenic types equally common. Prompt diagnosis and appropriate treatment, including aspiration for pyogenic cases, are crucial for managing pediatric liver abscesses.
Area of Science:
- Pediatric Infectious Diseases
- Hepatology
- Microbiology
Background:
- Liver abscesses in children are rare but serious infections.
- Differentiating between amebic and pyogenic liver abscesses is critical for appropriate management.
- This study reviews cases from a single center to understand the characteristics and outcomes of pediatric liver abscesses.
Observation:
- A total of 20 pediatric liver abscess cases were identified between March 1986 and March 1989.
- Ten cases were amebic liver abscesses and ten were pyogenic liver abscesses.
- The majority of abscesses (75%) were located in the right lobe of the liver.
Findings:
- Amebic liver abscesses showed positive serological tests in 80% of cases.
- Etiologic agents were identified in 50% of pyogenic liver abscesses, with E. coli and S. Aureus being the most common.
- Clinical features included hepatomegaly, fever, anemia, and abdominal pain. Abnormal prothrombin time and elevated sedimentation rates were common in both groups.
- Macroscopic appearance of aspirate was not diagnostic.
Implications:
- Amebic liver abscesses generally responded well to medical treatment (60% of cases).
- Pyogenic liver abscesses often required both medical treatment and needle aspiration (80% of cases).
- Early diagnosis and tailored treatment strategies are essential for improving outcomes in pediatric liver abscess patients.
Abstract:
Between March 1986 and March 1989, 20 children were diagnosed as having liver abscesses at the Pediatric Department of the Central Hospital in Valencia. 10 were amebic and 10 pyogenic abscesses. 85% occurred in children and 15% in infants. 15 of them (75%) were located in the right lobe, 80% of amebic abscesses had positive serological tests. An etiologic agent was found in 50% of the pyogenic abscesses (3: E. coli, 2: S. Aureus). 80 to 90% of patients presented abnormal prothrombin time. Sedimentation rate was very high in both groups, even at the discharge time. Hepatomegaly, fever, anemia and abdominal pain were the main clinical features. The macroscopic aspect of the aspirate was not helpful in the diagnosis. 60% of amebic liver abscesses needed only medical treatment but 80% of pyogenic abscesses deserved medical treatment and needle aspiration.