Successful antimicrobial therapy of hepatic, intra-abdominal and intrapelvic abscesses

Antimicrobial therapy without surgical drainage or therapeutic aspiration was effective in the management of four patients with deep abscesses ranging in diameter from 1.3 to 10.0 cm. Two of the patients had multiple hepatic abscesses, one had hepatic, intra-abdominal and intrapelvic abscesses, and one had an intrapelvic abscess alone. Anaerobic bacteria were isolated from the blood or abscesses in all four patients, and an aerobic-anaerobic infection was present in one patient. The patients were treated with metronidazole, alone or in combination with other antibiotics, for 3 to 6 weeks. Therefore, in selected patients with deep abscesses, a therapeutic trial of antimicrobial agents instead of surgery may be justified.