scholarly journals Pyogenic liver abscess in a child with concomitant infections – Staphylococcus aureus, Echinococcus multilocularis and Mycobacterium tuberculosis

2016 ◽  
Vol 53 (3) ◽  
pp. 270-275 ◽  
Author(s):  
D. Antolová ◽  
D. Hudáčková ◽  
M. Fecková ◽  
A. Feketeová ◽  
M. Szilágyová
Keyword(s):  
Staphylococcus Aureus ◽  
Mycobacterium Tuberculosis ◽  
Liver Abscess ◽  
Echinococcus Multilocularis ◽  
Clinical Presentation ◽  
Pyogenic Liver Abscess ◽  
Diagnostic Process ◽  
Bacterial Aetiology ◽  
Life Threatening ◽  
Altered Liver

SummaryPyogenic liver abscess is an uncommon but important and potentially life-threatening disease that occurs whenever there is failure of clearance of an infection in the liver. Work presents a rare case of pyogenic liver abscess with confirmed bacterial aetiology ofStaphylococcus aureus, subsequently confirmedEchinococcus multilocularisand suspectedMycobacterium tuberculosisliver infection in 6 years old child. Moreover, several other parasitic diseases were recorded. According to clinical presentation of diseases, it could be supposed that liver impairment caused by alveolar echinococcosis and potentially also byM. tuberculosiscould be the predisposition site for the capture ofStaphylococcus aureusin altered liver tissues during its haematogenous spreading, and thus contributed to the development and subsequent clinical presentation of pyogenic liver abscess. The presence of three different aetiological agents complicated the diagnostic process as well as the therapy of the patient and made her prognosis uncertain. Proper diagnosis of multiloculated liver abscesses, with echinococcosis and hepatic tuberculosis considered in the differential diagnosis, is therefore crucial to administration of early and appropriate treatment.

scholarly journals Clinical, Demographic, and Aetiological Profile of Liver Abscess in Children Admitted at a Tertiary Care Hospital - North India

2021 ◽  
Vol 8 (40) ◽  
pp. 3470-3476
Author(s):  
Navya Sree Manugu ◽  
Narayana Lunavath ◽  
Ramu Pedada
Keyword(s):  
Staphylococcus Aureus ◽  
Informed Consent ◽  
Liver Abscess ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Salmonella Typhi ◽  
Amoebic Liver Abscess ◽  
Care Hospital ◽  
Methicillin Resistant

BACKGROUND Amoebic liver abscess is the commonest extra intestinal site of invasive amoebiasis which mainly affects infants and young children. The incidence of pyogenic liver abscess is much higher among children in developing countries than those in developed countries. Diagnosis of liver abscess can be challenging and is often delayed; a high index of suspicion is necessary in children with risk factors. Children have unique set of predisposing causes for liver abscesses. The purpose of this study was to assess the clinical, demographic, and etiological profile of liver abscess in children between 1 month to 12 years of age. METHODS This is a prospective observational study conducted in the Department of Pediatrics, Chacha Nehru Bal Chikistalaya (An Autonomous Institute under Govt. of NCT (National Capital Territory) of Delhi, affiliated to University of Delhi), Delhi from July 2016 to August 2017. All children aged 1 month to 12 years admitted with liver abscess (included consecutively) were enrolled after considering inclusion and exclusion criteria. Written and informed consent was taken from parents/guardians of children aged less than 7 years. Informed assent was taken from children aged more than 7 years, along with written and informed consent from their parents/guardians. Their clinical characteristics, radiological features and laboratory data were analysed. RESULTS Most common age group suffering from liver abscess was 5 - 10 years with male preponderance. Majority of the children belonged to lower socio-economic class and half of them were suffering from malnutrition. Most common clinical presentation of children suffering from liver abscess was fever with pain abdomen and tender hepatomegaly. Majority of the children had leucocytosis, high level of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Deranged liver function test with coagulopathy was noted in more than half of the children suffering from liver abscess. Commonest bacterial pathogen was methicillin resistant Staphylococcus aureus followed by Salmonella typhi, Stenotrophomonas maltophilia, coagulase negative Staphylococcus aureus and Staphylococcus hominis. Entamoeba histolytica is a common parasitic agent causing liver abscess in children. CONCLUSIONS Liver abscess should be considered in children presenting with fever and abdominal pain. Most cases involve a single lesion on right lobe of the liver. Methicillin resistant Staphylococcus aureus followed by Salmonella typhi are the two most common pathogens. KEYWORDS Paediatric Liver Abscess, Amoebic Liver Abscess, Pyogenic Liver Abscess, Children

scholarly journals Liver Abscess: An Institutional Review at Gandaki Medical College Teaching Hospital

2017 ◽  
Vol 9 (2) ◽  
pp. 7-12
Author(s):  
Hari Bahadur KC ◽  
S Bhuju ◽  
R R Dhakal ◽  
D S Timilsina
Keyword(s):  
Liver Abscess ◽  
College Teaching ◽  
Pyogenic Liver Abscess ◽  
Biliary Tree ◽  
Needle Aspiration ◽  
Abnormal Liver Function Test ◽  
Female Ratio ◽  
Gastrointestinal Pathology ◽  
Image Guided Intervention ◽  
Life Threatening

Background: Although liver abscess is a potentially life threatening disease, early diagnosis and prompt treatment has resulted good clinical outcome. The epidemiology and management of this condition have evolved over time.Objective: To study our experience in clinical characteristics and management of liver abscess in a tertiary hospital over a period of three years.Methods: The hospital records of all patients discharged with the diagnosis of liver abscess from September 2010 to March 2013 were reviewed. The demographics, clinical presentation, investigation tools, method of treatment and outcome were recorded and analyzed.Results: Total of 17 patients of liver abscess were admitted during this period, of which, 13 were pyogenic and four amebic. The median age was 50 (7 - 75) years with male to female ratio of 1.42 : 1. Age group 40 - 60 years was most commonly affected. Single lesions were found in 11 (64.7%) and multiple in six (35.3%) patients. The most common presentation was fever and abdominal pain/tenderness. Jaundice was seen in five (29.4%) patients and abnormal liver function test in 10 (58.8%) patients. Commonest route of infection among pyogenic liver abscess were through biliary tree pathology (Five patients) and via portal venous system (Three patients). Pus and blood culture were positive in six (46.15%) and four (30.76%) patients respectively, and E. coli was the commonest pathogen isolated. Patients were treated with anti-microbial therapy and interventional radiology techniques: Nine patients with percutaneous needle aspiration, four with percutaneous drainage. Antibiotics alone were sufficient in three patients and open surgical drainage was required in one patient. There was one case of mortality where the abscess was associated with diabetes mellitus. Conclusion: Liver abscess is a potentially life threatening disease and commonly associated with underlying gastrointestinal pathology. Adequate antibiotic coverage and image guided intervention is optimal first-line treatment with favorable outcome.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 7-12

scholarly journals Liver abscess: presentation and an assesment of the outcome with various treatment modalities

2019 ◽  
Vol 6 (7) ◽  
pp. 2556 ◽  
Author(s):  
Sreeramulu P. N. ◽  
Srinivasan Dorai Swamy ◽  
Vikranth Suresh N. ◽  
Suma S.
Keyword(s):  
Liver Abscess ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Continuous Drainage ◽  
Right Lobe ◽  
Upper Abdominal

Background: Liver abscess is a disease of frequent occurrence which is important in the differential diagnosis of upper abdominal and right lower respiratory tract diseases. Liver abscess are space occupying lesion in liver which has a higher incidence of mortality and morbidity. The aim is to study the clinical presentation and compare the outcomes of various treatment modalities.Methods: A Retrospective Study was conducted over a period of 3 years from November 2016 to October 2019, in tertiary care centre, R. L. Jalappa hospital, Tamaka, Kolar, Karnataka, India. 46 cases of liver abscesses were studied. Complete clinical details about the clinical presentation of the cases, investigative work up and treatment modalities adopted were collected. The associated morbidity and mortality of all patients were reviewed.Results: In our study, the mean age was 49.5 years which included male patients most commonly. Pyogenic liver abscess was more common than amoebic liver abscess. Right lobe of the liver was most commonly involved. The common treatment modality was continuous drainage of the abscess cavity by the percutaneous insertion of a pig tail catheter. Surgical intervention for the rupture was done in one patient.Conclusions: In our experience of managing liver abscess, pyogenic liver abscess involving right lobe of the liver was common with the presentation of upper abdominal pain, high grade fever with chills and tender hepatomegaly. Ultrasound abdomen is very useful investigative tool in diagnosis and also in intervention and in the follow up of the condition and to evaluate progression or resolution.

scholarly journals Pyogenic Liver Abscess Secondary to Sigmoid Diverticulitis: An Unusual Presentation

2020 ◽  
Vol 14 (1) ◽  
pp. 165-171
Author(s):  
Edward Paul Joseph Muscat
Keyword(s):  
Liver Abscess ◽  
Present Report ◽  
Rare Complication ◽  
Pyogenic Liver Abscess ◽  
Mucosal Barrier ◽  
Sigmoid Diverticulitis ◽  
Delayed Presentation ◽  
Atypical Symptoms ◽  
Life Threatening ◽  
Inflammatory Bowel

Pyogenic liver abscesses, despite being a rare complication of diverticulitis and inflammatory bowel disease, are potentially serious life-threatening pathologies. Diverticular diseases can lead to disruption of the colonic mucosal barrier and can serve as a route for bacterial infection via the portal venous system. This patient had such a delayed presentation due to his atypical symptoms; he developed large abscess formation, detected by computed tomography, eventually requiring an ultrasound-guided drain followed by a colonoscopy. The present report describes an elderly gentleman who developed a bacterial liver abscess due to seeding of a commensal organism caused by sigmoid diverticulitis.

scholarly journals A retrospective analysis of pyogenic liver abscess and antibiotic resistivity of common pathogens in Peshawar

2020 ◽  
Vol 7 (12) ◽  
pp. 4190-4196
Author(s):  
Nadia Bashir ◽  
Muhammad Adnan Shereen ◽  
Abeer Kazmi ◽  
Muhammad Sajid ◽  
Hafiz Ullah
Keyword(s):  
Liver Abscess ◽  
Demographic Data ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Biochemical Tests ◽  
Female Ratio ◽  
Male Predominance ◽  
Demographic Study ◽  
Life Threatening ◽  
Sensitivity Rate

Background: Pyogenic liver abscess (PLA) is a rare but life-threatening disease, with a frequency ranging from 10.83 to 17.45 per 100,000 persons. The major cause of PLA is bacterial infection of liver parenchyma. The present research study was designed to investigate the common microbes causing PLA in Peshawar (Pakistan) and to evaluate a variety of the most capable and efficient antibiotics for treatment of PLA. Methods: A 7-year (2012 - 2018) retrospective demographic study of medical records of all PLA patients (n = 379) admitted to the Hayatabad Medical Complex (HMC) and Khyber Teaching Hospital (KTH) was initially performed. The demographic study was followed by biochemical tests and antibiotic resistivity tests of microorganisms, isolated from available samples and selected from literature using web services. Results & Conclusion: The demographic data revealed that 70% of the PLA patients were under the age of 50, with male predominance (male to female ratio of 3:1). It was concluded that K. pneumonia, poly-microbes (K. pneumonia and Citrobacter), and E. coli are the most common microbes involved in causing PLA in the population of Peshawar. E.coli, Citrobacter and K. pneumonia were sensitive to Cefixime and Ciprofloxacin (100% sensitivity rate), but showed significant resistance against Amoxycillin, Oxacillin and Fusidic Acid. It is, therefore, prudent to practice susceptibility-directed antibiotic therapy.

scholarly journals Characteristics of gas-forming pyogenic liver abscess caused by Klebsiella pneumoniae and Clostridi perfringens

2019 ◽  
Author(s):  
Zheng-Yang Chen ◽  
Nan Jiang ◽  
Song Guo ◽  
Bin-Bin Li ◽  
Jia-Qi Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Review Of Literature ◽  
Manual Search ◽  
Life Threatening ◽  
Low Incidence ◽  
Background Gas ◽  
Prevalence Of Diabetes Mellitus

Abstract Background: Gas-forming pyogenic liver abscess is a life-threatening disease with poor prognosis commonly caused by 2 bacteria, Klebsiella pneumoniae and Clostridium perfringens . Due to its low incidence and associated high mortality rate, it is important to study the biological characteristics of the disease. The aim of this study was to conduct a worldwide review of literature on gas-forming pyogenic liver abscess caused by K. pneumoniae and C. perfringens . Methods: We searched PubMed and Web of Science databases from January 2009 to March 2019, with published in English. All relevant articles were accessed in full text. The manual search included references of retrieved articles. Finally, 35 publications were selected for review. Results: The results showed that more cases of gas-forming pyogenic liver abscess in Asia were caused by K. pneumoniae than by C. perfringens (P=0.011). The prevalence of diabetes mellitus in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae was higher than caused by C. perfringens (P=0.032). The survival rate of patients with gas-forming pyogenic liver abscess caused by K. pneumoniae who received surgical debridement or drainage was higher than caused by C. perfringens (P=0.002). Conclusions: The prevalence of diabetes mellitus was higher in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae than in patients caused by C. perfringens .

scholarly journals Pyogenic Liver Abscess Caused by Methicillin-Susceptible Staphylococcus aureus in a 21-Year-Old Male

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Samuel Igbinedion ◽  
Meher S. Mavuram ◽  
Moheb Boktor ◽  
John Bienvenu
Keyword(s):  
Staphylococcus Aureus ◽  
Liver Abscess ◽  
Liver Enzymes ◽  
Pyogenic Liver Abscess ◽  
Severe Illness ◽  
Percutaneous Catheter ◽  
Liver Abscesses ◽  
Elevated Liver Enzymes ◽  
Antibiotic Coverage

Liver abscesses are the most common types of visceral abscesses. Pyogenic liver abscesses, a particular type of liver abscesses, are uncommonly encountered. We present a rare case of pyogenic liver abscess caused by methicillin-susceptible Staphylococcus aureus in a young man. A 21-year- old man presented from prison to the hospital with fever, nausea, vomiting, diarrhea, and abdominal pain for five days. Labs were significant for leukocytosis with predominant neutrophilia and elevated liver enzymes. CT abdomen with contrast revealed an 8.4 cm multiloculated right hepatic mass extending to the kidney. Patient was started on broad spectrum antibiotics, given septic presentation. Peripheral blood cultures returned positive for methicillin-susceptible Staphylococcus aureus (MSSA). The culture from percutaneous drainage also revealed MSSA. He received a total of four weeks of IV Nafcillin therapy along with drainage of his abscess via percutaneous catheter. Follow-up revealed clinical resolution. This case highlights the importance of obtaining an aspirate from the liver abscess to better guide treatment strategy. Clinicians must consider broadening antibiotic coverage to include gram-positive organisms if the patient presents with severe illness and risk factors for Staphylococcus aureus infections.

A Case of Pyogenic Liver Abscess Caused by Methicillin-susceptible Staphylococcus aureus

2017 ◽  
Vol 112 ◽  
pp. S1572
Author(s):  
Samuel O. Igbinedion ◽  
Meher S. Mavuram ◽  
Moheb Boktor ◽  
John Bienvenu
Keyword(s):  
Staphylococcus Aureus ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess
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