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Published on: February 9, 2011
Pyogenic liver abscess among children in a medical center in Central Taiwan
Yu-Lung Hsu1, Hsiao-Chuan Lin1, Ting-Yu Yen1
1Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan.
Insights
Pediatric pyogenic liver abscesses are rare but present with fever and abdominal pain. Klebsiella pneumoniae and Streptococcus spp. are common pathogens, with percutaneous drainage and antibiotics proving effective treatments.
Area of Science:
- Pediatric Infectious Diseases
- Hepatology
- Radiology
Background:
- Pediatric pyogenic liver abscess (PLA) is an uncommon but serious infection.
- Early recognition and appropriate management are crucial for favorable outcomes in children.
Purpose of the Study:
- To investigate the clinical characteristics, radiologic findings, causative pathogens, and treatment outcomes of pediatric PLA.
- To identify key indicators for diagnosis and effective management strategies.
Main Methods:
- Retrospective review of pediatric patients diagnosed with PLA between 1995 and 2011.
- Analysis of clinical data, imaging, laboratory results, and treatment interventions, excluding oncologic complications.
Main Results:
- Fifteen pediatric patients were identified, with fever and abdominal pain as primary symptoms.
- Klebsiella pneumoniae and Streptococcus spp. were the most frequent pathogens identified in abscess pus.
- Percutaneous drainage and parenteral antibiotics demonstrated high efficacy, with no reported mortalities.
Conclusions:
- Pediatric PLA should be suspected in children with fever, abdominal pain, leukocytosis, and elevated CRP.
- A single abscess in the right liver lobe is a common presentation.
- Prompt drainage and targeted antibiotic therapy are essential for successful treatment.
Background:
Pediatric pyogenic liver abscess is uncommon. This study aimed to investigate the clinical characteristics, radiologic features, pathogens, duration of hospitalization, and management of pediatric pyogenic liver abscess.
Methods:
Pediatric patients with pyogenic liver abscess admitted to the China Medical University Hospital from 1995 to 2011 were reviewed. Their clinical characteristics, radiological features, laboratory data, clinical management, and outcomes were analyzed. Those with liver abscess due to the complication of oncologic disease were excluded.
Results:
Fifteen patients were diagnosed with pyogenic liver abscess. Their most common symptoms were fever and abdominal pain. Eight (53.0%) had leukocytosis (>15000/μL) and elevated C-reactive protein (CRP) level (>10 mg/dL). The main imaging presentation was a single abscess in right lobe of the liver (13/15, 86.7%). Blood culture were mainly negative (12/15, 80.0%). Pathogenic microorganisms cultured from pus revealed Klebsiella pneumoniae (6/15, 40.0%) and Streptococcus spp. (6/15, 40.0%) as the two most common pathogens. Percutaneous abscess drainage followed by adequate parenteral antibiotics were effective interventions. Hospitalization of at least 2 weeks was needed in most cases. There were no mortalities.
Conclusion:
Pyogenic liver abscess should be considered in children presenting with fever, abdominal pain, and leukocytosis with a high CRP level. Most cases involve a single lesion on right lobe of the liver. K. pneumoniae and Streptococcus spp. are the two most common pathogens. Drainage with adequate antibiotics has significantly good response.
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