scholarly journals Diabetes Mellitus and Pyogenic Liver Abscess: Risk and Prognosis

2007 ◽  
Vol 45 (6) ◽  
pp. 801-801 ◽  
Author(s):  
Y. Keynan ◽  
E. Rubinstein
Author(s):  
José F Sotillo-Lindo ◽  
Bustamante Bustamante ◽  
Magda Rojas ◽  
Kathia Luciani

El absceso hepático es un reto diagnóstico y terapéutico. Es una patología poco frecuente en la niñez que predomina en países en desarrollo y se asocia a malnutrición y parasitosis. El absceso hepático piógeno es el más frecuente, es una causa de hospitalización prolongada por el requerimiento de antimicrobianos endovenosos; usualmente con baja mortalidad.A continuación, presentamos una serie de cuatro casos clínicos de pacientes con abscesos hepáticos piógenos que fueron manejados entre el 2016 y 2018 en el Hospital de Especialidades Pediátricas.Tres pacientes fueron del sexo femenino y uno masculino. En dos de los pacientes se identi có factor predisponente: diabetes mellitus e infección avanzada por VIH. Los síntomas más frecuentes fueron ebre (100%), dolor abdominal (100%) y hepatomegalia (50%). En ninguno de los casos se sospechó absceso hepático a su ingreso. Los casos fueron diagnosticados por sonograma hepático y corroborados con tomografía abdominal. El tamaño promedio de las lesiones fue de 6.88 x 6.18 x 6.12 cm. Tres fueron de localización derecha y uno de localización izquierda. Todos los pacientes recibieron antibioticoterapia de amplio espectro y drenaje percutáneo. Se identi có agente etiológico en uno de los pacientes: Staphylococcus aureus.Los pacientes recibieron una media de 33 + 3.5 días de tratamiento. Con evolución favorable en todos los casos y mejoría en seguimiento con ultrasonidos. Ningún paciente requirió intervención quirúrgica. Abstract The liver abscess involves an authentic diagnostic and therapeutic challenge. It is not frecuent in childhood. Occurs mainly in developing countries and is associated to malnutrition and parasitic infection, that are described as risk factors. Pyogenic liver abscess represents, in most of the cases, a cause of long-time hospitalizations because of the requirement of endovenous treatment, but usually with low mortality.We describe a four-case series of patients with pyogenic liver abscess between 2016 and 2018 in Hospital de Especialidades Pediatricas in Panamá City.Three patients were female and one was a male. In two of the cases, there were risk factors such as diabetes mellitus and advanced HIV infection.The most frequent symptoms were: fever (100%), abdominal pain (100%) and hepatomegaly (50%).In neither one of the cases, liver abscess was suspected as diagnosis. All cases were diagnosed by hepatic sonogram and con rmed by abdominal CT- scan. The mean size of lesions was 6.88 x 6.18 x 6.12 cm. Three of the cases were located in right lobe and one in the left lobe of the liver. They were managed with broad-spectrum antibiotics and percutaneous drainage.Staphylococcus aureus was isolated in one case.The patients received a mean of 33 + 3.5 days of treatment. All cases evolved well with improvement of lesion in ultrasonography. None of the patients required surgical intervention.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhaoqing Du ◽  
Xingchen Zhou ◽  
Junzhou Zhao ◽  
Jianbin Bi ◽  
Yifan Ren ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Magdelene Amoateng ◽  
Pius Osei-Bagyina ◽  
Reba Varughese ◽  
Achsah Mathew ◽  
Ishan Malhotra

Klebsiella pneumoniae liver abscess (KPLA) is an emerging syndrome with the initial cases described in Taiwan in the 1980s. There is high mortality with this condition, and immediate aggressive treatment is necessary. Diabetes mellitus (D.M.) is the single most important risk factor for developing KPLA. Here, we describe a rare case of recurrent cryptogenic Klebsiella pneumoniae pyogenic liver abscess (KPLA) in a young man with poorly controlled type 1 D.M.


2021 ◽  
pp. 30-32
Author(s):  
Bharat Bhushan ◽  
Debarshi Jana

Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical prole of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given. Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation prole (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done. Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%). Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality


Author(s):  
Vineet Jain ◽  
Smita Manjavkar ◽  
Prem Kapur ◽  
. Durfishan ◽  
Divya Rajput ◽  
...  

Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical profile of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given.Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done.Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%).Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality.


2013 ◽  
Vol 61 (5) ◽  
pp. 837-838 ◽  
Author(s):  
Min-Po Ho ◽  
An-Hsun Chou ◽  
Wing-Keung Cheung

Liver abscess is a serious intraabdominal infection can be due to result of bacteria, fungi, or parasites infection. Until the end of the last century, pyogenic liver abscesses were predominantly caused by mixed aerobic and anaerobic bacteria, the most frequent isolate being Escherichia coli [1]. Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Patients with diabetes mellitus and the preexisting hepatobiliary disease are particularly susceptible to infection as well as those from Southeast Asia [2]. We present a case of Klebsiella liver abscess with bacteremia.


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