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 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 Prospective study of etiology of liver abscess and comparison of different ways of its management

2020 ◽  
Vol 7 (8) ◽  
pp. 2532
Author(s):  
Anand Kumar Jaiswal ◽  
R. K. Jain ◽  
Rahul Sarin
Keyword(s):  
Prospective Study ◽  
Liver Abscess ◽  
Communicable Disease ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Amoebic Liver Abscess ◽  
Western World ◽  
Male Predominance ◽  
Medical College ◽  
A Prospective Study

Background: Liver abscess is a collection of purulent material in the liver parenchyma which can be due to bacterial, parasitic, fungal or mixed infection. It has become one of the most common communicable disease with much more prevalence in underdeveloped and developing countries. Two most common type of liver abscess are amoebic and pyogenic. Pyogenic liver abscess is more common in western world while amoebic liver abscess is more commonly found in third world countries, which are under developed, and more people living under lower socio economic conditions.Methods: A prospective study of 50 patients with clinical diagnosis of liver abscess admitted in the department of surgery B. R. D. Medical College Gorakhpur during a period of one year.Results: There was male predominance (98%) and most of the patient belongs to younger age group and low socio economics status. In amoebic liver abscess there was strong correlation with alcohol intake (66%).Conclusions: In our study most of the patients were group 21-30 years and the most common presenting symptom was right upper quadrant pain and fever. In most of the patients, the common hematological finding was mild anaemia with leucocytosis with altered LFT.

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 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.

Pathology of Pyogenic Liver Abscess in Children

1999 ◽  
Vol 2 (6) ◽  
pp. 537-543 ◽  
Author(s):  
Fausto E.L. Pereira ◽  
Carlos Musso ◽  
Jane S. Castelo
Keyword(s):  
Liver Abscess ◽  
Liver Tissue ◽  
Penetrating Trauma ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Larva Migrans ◽  
Morphological Evidence ◽  
Predisposing Factor ◽  
The Right

Little is known about preexisting lesions in livers of children with pyogenic liver abscess (PLA). Study of these lesions may elucidate possible predisposing factors for the disease. In Vitória, state of Espirito Santo, Brazil, PLA in children is frequently associated with helminthic infections and eosinophilia. We hypothesize that nematode infection with larvae migrating through the liver is a predisposing factor for PLA, because the infection induces immunomodulation and likely trapping of bacteria in liver granulomas. In this report, we describe observations of 22 cases of PLA in children studied at autopsy (16 cases) or in surgical biopsies (6 cases), including 17 boys and 5 girls ranging in age from 1 to 13 years (mean 4.6 years, median 3.5 years). Multiple abscesses in both lobes were found in 13 cases and a single abscess was found in the right lobe in 10 cases. All cases showed histologically classical pyogenic inflammation without morphological evidence of amoebiasis. In six cases there were granulomas similar to those caused by larva migrans visceralis (from Toxocara or other nematodes) in liver tissue not affected by the abscess. Nematode antigens in central areas of necrosis of granuloma in all six cases and fragments of a larva, possibly of Toxocara, were found on samples immunohistochemically stained with polyclonal anti- Toxocara antibodies. There were numerous eosinophils in abscesses with Charcot-Leyden crystals. Eosinophils were found frequently in portal triads far from the abscess wall. In four cases, in which bile duct ascariasis was found, worms were noted in the bile ducts, and eggs were found in liver parenchyma surrounding the abscess in two cases. Foreign-body granulomas were found in one case in which penetrating trauma was the cause of abscess. In one case there was one histiocytic granuloma whose origin was not determined. The observation of six cases of granuloma similar to larva migrans visceralis (or produced by other nematode larva) in liver tissue not directly affected by the abscess supports the hypothesis that helminth infections with larva migrating through the liver are a predisposing factor for pyogenic hepatic abscess in children.

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 Multiple Pyogenic Liver Abscess

2013 ◽  
Vol 5 (2) ◽  
pp. 137-139
Author(s):  
Deepak Madi ◽  
Basavaprabhu Achappa ◽  
Mridula Laxman ◽  
John T Ramapuram ◽  
Nithyananda Chowta ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Complete Resolution ◽  
Medical Science ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Science Volume ◽  
Ultrasound Guided ◽  
Liver Abscesses ◽  
Threatening Condition ◽  
Life Threatening

Multiple liver abscess is a life threatening condition with high mortality. We present a case of a 59 yr old gentleman who developed multiple hepatic abscesses due to an appendicular mass. He was treated with parenteral antibiotics and ultrasound guided needle aspiration of the largest abscess was done. He recovered promptly with complete resolution of the liver abscesses. The main aim of this case report is to highlight the fact that multiple pyogenic liver abscesses can be managed with antibiotic treatment and needle aspiration. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8725 Asian Journal of Medical Science, Volume-5(2) 2014: 137-139

scholarly journals Liver abscess presentation and management: a retrospective study

2017 ◽  
Vol 4 (2) ◽  
pp. 550
Author(s):  
Kemparaj T. ◽  
Mohammed Rehan Khan ◽  
Sagar Narayan
Keyword(s):  
Retrospective Study ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Needle Aspiration ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Microbiological Analysis ◽  
Right Lobe ◽  
Common Sign

Background: Liver abscess is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. It is a common condition across the globe. The aim was to study the clinical profile, microbiological aetiology, and investigation profile and treatment outcomes in patients with liver abscess.Methods: A retrospective study was conducted from January 2010 to December 2014 on 200 consecutive liver abscess patients at Bowring and Lady Curzon hospital, BMC and RI, Bangalore, Karnataka, India. Medical records were analysed for clinical features, examination findings, laboratory investigations, radiological tests, microbiological analysis and treatment modalities. Descriptive statistics were used.Results: The mean age of patients was 42.25 years. Majority were male alcoholics. The abscesses were commonly in right lobe (80%) and solitary (72%). Abscesses were predominantly amoebic in 72%. Percutaneous needle aspiration was done in 34%, pigtail drainage in 48% and surgical intervention for rupture in 4% patients. Mortality was 2.5% with all death reported in surgical group.Conclusions: Amoebic liver abscess is more common than pyogenic liver abscess. Commonly occurs in young alcoholic males. Most common presenting feature is pain abdomen followed by fever. Most common sign include tender hepatomegaly. Ultrasound abdomen is useful not only in diagnosis and intervention but also in the follow up of the condition and to assess resolution.

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