scholarly journals Evaluation of clinical risk factors for developing pleural empyema secondary to liver abscess

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Eunjue Yi ◽  
Tae Hyung Kim ◽  
Jun Hee Lee ◽  
Jae Ho Chung ◽  
Sungho Lee
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Liver Abscess ◽  
Biliary Tract ◽  
Clinical Manifestation ◽  
Pyogenic Liver Abscess ◽  
Pleural Empyema ◽  
Patient Characteristics ◽  
Group 2 ◽  
The Right

Abstract Background The aim of this study was to investigate the clinical manifestation and predictive risk factors of pleural empyema developing during treatment of the pyogenic liver abscess. Methods Medical records of patients with the liver abscess in our institution were reviewed retrospectively. Enrolled patients were classified into four groups; Group 1: patients without pleural effusion, Group 2: patients with pleural effusion and who were treated noninvasively, Group 3: patient with pleural effusion and who were treated with thoracentesis, and Group 4: patients with pleural effusion that developed into empyema. Patient characteristics, clinical manifestation, and possible risk factors in development of empyema were analyzed. Results A total of 234 patients was enrolled in this study. The incidence rate of empyema was 4.27% (10 patients). The mean interval for developing pleural effusion was 5.6 ± 6.35 days. In multivariate analysis, risk factors for developing pleural effusion included the location of the liver abscess near the right diaphragm (segment 7 and 8, OR = 2.30, p = 0.048), and larger diameter of the liver abscess (OR = 1.02, p = 0.042). Among patients who developed pleural effusions, presences of mixed microorganisms from culture of liver aspirates (OR = 10.62, p = 0.044), bilateral pleural effusion (OR = 46.72, p = 0.012) and combined biliary tract inflammation (OR = 21.05, p = 0.040) were significantly associated with the need for invasive intervention including surgery on effusion. Conclusion The location of the liver abscess as well as pleural effusion, elevated inflammatory markers, and combined biliary tract inflammation may be important markers of developing pleural complication in patients with pyogenic liver abscess.

scholarly journals Pyogenic liver abscess caused by Gemella morbillorum

2014 ◽  
pp. 81-84 ◽  
Author(s):  
Paolo Borro ◽  
Alessandro Sumberaz ◽  
Gianni Testino
Keyword(s):  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Pleural Empyema ◽  
Abdominal Ultrasound ◽  
Needle Aspiration ◽  
Focal Lesions ◽  
Simple Cyst ◽  
Systemic Antibiotic Therapy ◽  
The Right

Even though Gemella morbillorum infection (GMI) is rare in humans, it may, nevertheless, cause endocarditis, meningitis, brain abscess, pleural empyema, nephritis, mediastinitis, and – occasionally – liver abscess. We are describing the case of a 64-year-old Caucasian male admitted with fever and abdominal pain. Laboratory parameters revealed inflammation signs, and instrumental examinations showed the presence of diverticula in the ascending colon. Abdominal ultrasound (US) and computer tomography (CT) showed two focal lesions in the right liver lobe. One had the characteristics of a simple cyst; the second was hypoechoic with a low density area, possibly containing necrotic material. US-guided needle biopsy was found negative for neoplastic cells, showing purulent infiltrate. Pus culture was found positive for GMI. Systemic antibiotic therapy, coupled with repeated US-guided needle aspiration, induced the resolution of the hepatic abscess. Few cases have been reported of hepatic abscess caused by GMI in immunocompetent non-cirrhotic subjects.

Absceso hepático piógeno en pediatría: serie de casos

2019 ◽  
pp. 13-19
Author(s):  
José F Sotillo-Lindo ◽  
Bustamante Bustamante ◽  
Magda Rojas ◽  
Kathia Luciani
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Abscess ◽  
Parasitic Infection ◽  
Case Series ◽  
Pyogenic Liver Abscess ◽  
Left Lobe ◽  
Long Time ◽  
Mean Size ◽  
Right Lobe

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.

scholarly journals Mortality Risk Factors in Patients with Pyogenic Liver Abscess

2021 ◽  
Vol 05 (09) ◽  
Author(s):  
dos Santos-Rosa OM ◽  
dos Santos RLC ◽  
Favaro ML ◽  
Fonseca AZ ◽  
Junior MAFR
Keyword(s):  
Risk Factors ◽  
Liver Abscess ◽  
Mortality Risk ◽  
Pyogenic Liver Abscess

Risk Factors, Management, and Outcomes of Pyogenic Liver Abscess in a US Safety Net Hospital

2019 ◽  
Vol 65 (5) ◽  
pp. 1529-1538 ◽  
Author(s):  
V. V. P. K. Mukthinuthalapati ◽  
Bashar M. Attar ◽  
L. Parra-Rodriguez ◽  
Nicolo L. Cabrera ◽  
Tiago Araujo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Safety Net ◽  
Safety Net Hospital

scholarly journals Puerperal sepsis caused by liver abscess: case report

2017 ◽  
Vol 17 (4) ◽  
pp. 853-858
Author(s):  
Flávio Xavier Silva ◽  
Alex Sandro Rolland Souza
Keyword(s):  
Intensive Care ◽  
Liver Abscess ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Good Health ◽  
Recurrent Pain ◽  
Laboratory Findings ◽  
The Right

Abstract Introduction: sepsis is a serious public health problem, affecting millions of people in the world each year, with a high mortality rate (one out of four patients) and an increasing incidence. Sepsis is one of the main causes of maternal mortality and an important cause of admission to obstetric intensive care units. Case description: In this study, the authors report the case of a woman having been submitted to cesarean section three days before presenting clinical signs of sepsis and septic shock caused by a liver abscess. The patient had a set of complications secondary to shock, such as thrombocytopenia, coagulopathy, toe ischemia and acute kidney failure. The patient had cholelithiasis and recurrent pain in the right hypochondrium during pregnancy. During hospitalization, the mechanism involved in the development of hepatic abscess was infection of the biliary tract. The patient was treated in an obstetric intensive care unit with antibiotics and drainage of the liver abscess. Progress was favorable and the patient was discharged in good health. Discussion: pyogenic liver abscess during pregnancy and puerperium is a serious condition which represents a diagnostic and therapeutic challenge, with few cases reported. The normally nonspecific clinical and laboratory findings can lead to a late diagnosis, which increases the risk of maternal morbidity and mortality.

Pyogenic Liver Abscess Following Pancreaticoduodenectomy: Risk Factors, Treatment, and Long-Term Outcome

2014 ◽  
Vol 18 (5) ◽  
pp. 922-928 ◽  
Author(s):  
Victor C. Njoku ◽  
Thomas J. Howard ◽  
Changyu Shen ◽  
Nicholas J. Zyromski ◽  
C. Max Schmidt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S548-S548
Author(s):  
Jennifer A Losie ◽  
John Lam ◽  
Dan Gregson ◽  
Michael Parkins
Keyword(s):  
Risk Factors ◽  
Liver Abscess ◽  
Klebsiella Oxytoca ◽  
Epidemiological Data ◽  
Pyogenic Liver Abscess ◽  
Population Based ◽  
Population Based Study ◽  
Streptococcus Anginosus ◽  
Health Zone ◽  
General Populations

Abstract Background Pyogenic liver abscess (PLA) is a significant cause of morbidity and mortality. Epidemiological data regarding risk factors and outcome determinants are often ascertained from referral population bases. We utilized a population-based study design to better understand PLA. Methods Calgary Health Zone (CHZ) residents ≥18 years of age (population ~1.3 million) who were hospitalized with PLA in 2017 were included. Charts were manually reviewed to determine demographics and clinical outcomes. Univariate and multivariate logistic regression were used to assess for factors associated with 30-day mortality using STATA 15.1 (College Stn., TX). Results Forty-four patients with PLA were identified (39% female, median age 61 [IQR 56–68] years) corresponding to an incidence rate of 3.7 cases per 100,000 population. Prevalent co-morbidities with PLA included; hemodialysis dependence (4.5%), cancer (25%), diabetes (23%), and cirrhosis (6.8%), each of which was significantly more common (P < 0.05) than in the general population; 85.3X, 11.2X, 3.6X, 29.9X, respectively. Rates of other comorbidities including ischemic heart disease, COPD, and rheumatoid arthritis did not differ from general populations (P > 0.05). The etiology of PLA was established in 72% of cases, of which biliary was most common (48%). Most (91%) cases had at least one organism identified via blood or liver aspirate culture. The most common organisms were Streptococcus anginosus group (12), Klebsiella pneumoniae (11), Klebsiella oxytoca (6), Escherichia coli (4), and obligate anaerobes (3). Blood cultures were positive in 25/44 (56%) cases. Thirty-day mortality from admission was 11% and had multiple risk factors (Table-1). Conclusion PLA in the CHZ is common and associated with high mortality. Understanding factors influencing PLA occurrence and outcome can assist in correctly identifying and optimally treating patients. Disclosures All authors: No reported disclosures.

Pyogenic Liver Abscess: An Audit of 10 Years’ Experience and Analysis of Risk Factors / with Invited Commentary

2001 ◽  
Vol 18 (6) ◽  
pp. 459-466 ◽  
Author(s):  
King-Teh Lee ◽  
Sen-Ren Wong ◽  
Pai-Ching Sheen
Keyword(s):  
Risk Factors ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess

scholarly journals ABSES HATI PIOGENIK

2012 ◽  
Vol 36 (1) ◽  
pp. 106
Author(s):  
Yusri Dianne Jurnalis ◽  
Delfican Delfican ◽  
Yorva Sayoeti
Keyword(s):  
Liver Abscess ◽  
Clinical Symptoms ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Surgical Drainage ◽  
Percutaneous Aspiration ◽  
High Grade Fever ◽  
Threatening Condition ◽  
Upper Abdominal ◽  
The Right

AbstrakAbses hati piogenik merupakan suatu kondisi yang berat dan mengancam kehidupan dengan angka mortalitas yang tinggi sehingga membutuhkan diagnostik dan terapi yang akurat. Gejala yang paling sering ditemukan adalah nyeri perut bagian atas, hepatomegali, demam tinggi, mual dan muntah. Gejala ini bervariasi sesuai ukuran abses, keadaan umum pasien, adanya penyakit dasar dan komplikasi. Pada sebagian besar kasus, penyakit dasarnya tidak diketahui. Abses biasanya soliter dan terletak di lobus kanan hati. USG dan CT scan abdomen merupakan sarana diagnostik utama. Abses hati piogenik diterapi dengan aspirasi perkutaneus bersamaan dengan antibiotik. Jika gagal, drainase dengan pembedahan dibutuhkan. Dengan adanya terapi invasif yang minimal seperti aspirasi jarum perkutaneus atau drainase kateter yang dipandu secara radiologis serta ketersediaan antibiotik berspektrum luas, pasien jarang membutuhkan tindakan pembedahan saat ini.Kata kunci : abses hati piogenik, aspirasi perkutaneus, drainase bedahAbstractPyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The most common presenting clinical symptoms are upper abdominal pain, tenderness, hepatomegaly, high-grade fever, nausea and vomiting. These features are variable depending upon the size of the abscess, general health of the patient, associated diseases and complications. In majority of the cases, the underlying cause could not be identified. Majority of abscesses are solitary and are noted in the right lobe of liver. USG and CT of the abdomen are the main tools of diagnosis. PLAs are mainly treated by percutaneous aspiration under antibiotic cover. If fails, surgical drainage becomes necessary. However, with the advent of minimally invasive therapy such as image-guided percutaneous needle aspiration or catheter drainage and the availability of broadspectrum antibiotics, patients with PLA nowadays seldom require open surgery for treatment.Key word : pyogenic liver abscess, percutaneous aspiration, surgical drainage

scholarly journals Epidemiology and risk factors for pyogenic liver abscess in the Calgary Health Zone revisited: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jennifer A. Losie ◽  
John C. Lam ◽  
Daniel B. Gregson ◽  
Michael D. Parkins
Keyword(s):  
Risk Factors ◽  
Incidence Rate ◽  
Liver Abscess ◽  
Census Data ◽  
Pyogenic Liver Abscess ◽  
Analysis Data ◽  
Mortality Rates ◽  
Health Concern ◽  
Incidence And Mortality ◽  
Health Zone

Abstract Background Pyogenic liver abscess (PLA), although uncommon in North America, is associated with significant morbidity and mortality. We sought to re-examine the epidemiology, risk factors, and outcomes of PLA in a large, diverse Canadian health zone. Methods All Calgary Health Zone (CHZ) residents aged ≥20 with PLA between 2015 and 2017 were identified. Incidence and mortality rates were calculated using census data. Risk factors for PLA were identified using a multivariate analysis. Data was compared to 1999–2003 data, also collected in the CHZ. Results There were 136 patients diagnosed with PLA between 2015 and 2017. Incidence rate during this period increased significantly relative to 1999–2003 (3.7 vs 2.3 cases/100,000 population, p < 0.01), however, mortality rates remained similar. The microbiological composition of PLA did not change over this 15-year time period but the number of antimicrobial resistant isolates did increase (8% vs 1%, p = 0.04). The greatest risk factors for PLA relative to general populations included current malignancy, liver-transplant, end-stage renal disease, and cirrhosis. Thirty-day mortality was 7.4% and independent risk factors included polymicrobial bacteremia, absence of abscess drainage, congestive-heart failure, a history of liver disease, and admission bilirubin. Conclusions Pyogenic liver abscess is a health concern with rising incidence rate. The increasing prevalence of comorbidities in our population and factors that are associated with risk of PLA suggests this will continue to be an emerging diagnosis of concern. Increasing prevalence of antibiotic resistant organisms compounding unclear optimal treatment regimens is an issue that requires urgent study.

Sign in / Sign up

Export Citation Format

Share Document