scholarly journals Clinical profile and management of pyogenic liver abscesses in a tertiary care hospital

2019 ◽  
Vol 8 (1) ◽  
pp. 52 ◽  
Author(s):  
Shyam K. Gupta ◽  
Ashufta Rasool ◽  
Aamir H. Hela ◽  
Rohit Goel ◽  
Zahur Hussain
Keyword(s):  
Liver Abscess ◽  
Percutaneous Drainage ◽  
Tertiary Care ◽  
Management Strategies ◽  
Standard Of Care ◽  
Pyogenic Liver Abscess ◽  
Modern World ◽  
Care Hospital ◽  
Medical College ◽  
Liver Abscesses

Background: Pyogenic Liver abscesses are potentially life threatening if left untreated. They pose a major Diagnostic and therapeutic challenge to modern world. Interventional radiology is becoming standard of care for liver Abscesses.Methods: All patients of pyogenic liver abscess admitted to Government Medical College and hospital Jammu, J and K, India from October 2018 to November 2019 were prospectively studied. Demographics, presentation, lab reports and management strategies were evaluated.Results: Total of 60 patients of pyogenic liver abscesses were studied with 81.7% males. Alcohol was found to be most common risk factor with 55% of patients being alcoholic. Right lobe of liver was involved in 66.7% of patients. Segment VI and VII were involved in 50% of patients. The most common clinical symptom was right upper quadrant pain (98.3%), followed by fever (91.7%). The most common clinical sign was right upper quadrant tenderness (91.7%). Percutaneous drainage with catheter placement was the most common and successful modality of management associated with least hospital stay.Conclusions: Pyogenic liver abscess is a rare but serious problem. Early diagnosis and treatment are necessary to avoid mortality. Percutaneous drainage along with I.V antibiotics is the best form of management.

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

Clinico-pathological Profile of Pyogenic Liver Abscess: An Experience from Tertiary Care Hospital from Kashmir Valley

2018 ◽  
Vol 25 (6) ◽  
pp. 1-13
Author(s):  
Mumtaz Wani ◽  
Mushtaq Chalkoo ◽  
Zahid Rather ◽  
Awhad Yousuf ◽  
Syed Arsalan ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Care Hospital ◽  
Kashmir Valley

A clinical profile of patients with liver abscess at a rural tertiary care centre at the MGM medical college

2021 ◽  
Vol 11 (2) ◽  
pp. 122-128
Author(s):  
Vandana Kumari ◽  
Keyword(s):  
Liver Abscess ◽  
Rural Areas ◽  
Single Case ◽  
Tertiary Care ◽  
White Blood Cells ◽  
Tertiary Care Centre ◽  
Optimal Test ◽  
Medical College ◽  
Liver Abscesses ◽  
Study Results

A liver abscess, also known as a hepatic abscess, is an accumulation of pus within the liver as a result of an infection. Overall liver abscesses are fairly rare and more frequently seen in developing nations. Most liver abscesses are caused by bacteria and amebic parasites (protozoa). However, other protozoa, fungi and helminths (parasitic worms) may also be responsible for hepatic abscesses. Methods: The present study was conducted in the indoor patients of medicine ward as well as on patients attending medicine OPD at M.G.M. Medical College and L.S.K. Hospital Kishanganj, Bihar. This study included 60 patients, out of 75 patients who were reported in Outdoor or admitted in Emergency Department remaining 15 patients were dropped out. The study period was Nov 2017 to September 2018 in M.G.M. Medical College and L.S.K. Hospital. The selection of the patients was based on clinical history, clinical examination and ultrasound findings. Those patients who were serologically positive for viral hepatitis, malaria (optimal test) and kalazar (rK 39) were excluded from this study. Results: There are 85 % male and 15 % female in this study. Age range varied from 12 to 70 years. The highest incidence was found in 31-40-year age group. Maximum number of cases were from rural areas 78.3% and remaining 21.7% from urban. The majority of cases 42/60 had leukocytosis (median -14,100) but 18 cases had white blood cells count within normal limit. Polymorphnuclear cells (median-81%) were predominantely present. Abnormally high alkaline phosphatase were seen in 82% of cases. There were six cases in which E. histolytica was detected in routine examination of stool. No single case was seropositive to HIV I and II serum creatinine level found to be within normal range in all cases. Conclusion: There was no mortality. Prognosis was better. It was due to early diagnosis of the diseases and early intervention.

scholarly journals Culture Sensitivity Patterns and Outcome of Liver Abscess in Children Admitted at a Tertiary Care Hospital in North India

2021 ◽  
Vol 8 (41) ◽  
pp. 3506-3512
Author(s):  
Navya Sree Manugu ◽  
Narayana Lunavath ◽  
Ramu Pedada
Keyword(s):  
Liver Abscess ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Fungal Culture ◽  
Care Hospital ◽  
Sensitivity Pattern ◽  
Culture Sensitivity ◽  
Empirical Antibiotics

BACKGROUND Liver abscess has been recognised since the time of Hippocrates. Liver abscess is defined as collection of purulent material in liver parenchyma. They are usually caused by bacterial and amoebic infections, and less commonly, by other protozoal and helminthic organisms. 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. The purpose of this study was to evaluate culture sensitivity pattern (Blood & Pus) of liver abscess in children. METHODS This prospective observational study was conducted in the Department of Paediatrics, Chacha Nehru Bal Chikistalaya, Delhi from July 2016 –to August 2017. This study has got Institutional Ethics Committee approval (Regd No: IEC/MAMC/78, Dt: 26/07/2016). 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. Their clinical characteristics, radiological features, laboratory data, clinical management, and outcomes were analysed. RESULTS In our study, out of 70 patients, 3.2 % patients showed growth in the blood culture. Organsims isolated were Methicillin resistant Staphylococcus aureus (MRSA) 1.4 % (1), Salmonella typhi 1.4 % (1), staphylococcus coagulase negative 1.4 % (1). Out of 70 patients of liver abscess enrolled in the study, 36 patients underwent aspiration of pus from the abscess. Out of 36 aspirated cases, gram positive cocci was identified in 1 (1.4 %) patient. In our study, no acid fast bacilli was identified and no fungal culture showed growth of organism. Out of 70 cases of liver abscess, 10 were found to be amoebic liver abscess. In our study, all the 70 patients were started on empirical antibiotics. Out of 70 patients, surgical intervention was done in 36 patients. In our study all the patients were started on empirical antibiotics according to hospital protocol. CONCLUSIONS Liver abscess should be considered in children presenting with fever and abdominal pain. Organisms recovered from liver abscesses vary greatly. Surgical drainage has been the traditional mode of treatment of pyogenic liver abscess, but this was replaced by IV broad-spectrum antibiotics and imaging-guided percutaneous drainage. KEYWORDS Paediatric Liver Abscess, Amoebic Liver Abscess, Pyogenic Liver Abscess, Culture-Sensitivity, Children

scholarly journals Retinoblastoma: A retrospective analysis of 141 patients from 1983 to 2013 at a tertiary care hospital in Nagpur, India

2019 ◽  
Vol 08 (03) ◽  
pp. 195-197
Author(s):  
Rohit S. Kabre ◽  
Krishna M. Kamble
Keyword(s):  
Retrospective Analysis ◽  
Tertiary Care Hospital ◽  
External Beam Radiotherapy ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Invasive Disease ◽  
Care Hospital ◽  
Medical College ◽  
Unilateral Disease ◽  
Clinical Records

Abstract Purpose: There is scarcity of data regarding clinical presentation and outcome of retinoblastoma patients in India. Objectives: The objective of this study was to assess the clinical profile of retinoblastoma patients in a tertiary care hospital in India from 1983 to 2013. Subjects and Methods: A retrospective analysis of clinical records of 141 patients with retinoblastoma registered from 1983 to 2013 at Government Medical College, Nagpur, India, was conducted. Demographics, clinical features, modes of treatment, and outcome of the patients were assessed. Results: Majority of patients (81 [57.45%]) presented in the age group of 1–3 years and were males. One hundred and fourteen patients (80.85%) had unilateral disease, while rare presentations of trilateral/quadrilateral retinoblastoma were also noted. Proptosis was seen in 81 (57.45%) patients as presenting symptom. Eighty-nine patients (63.12%) had locally invasive disease-involving sites. Forty-four patients (31.19%) developed distant metastasis. Surgical management and external beam radiotherapy were followed in majority of patients. Trend of increased usage of chemotherapy was seen from the mid-1990s. One hundred and twelve patients (79.43%) died with the disease. Conclusions: Data from this study show late diagnosis, leading to poor outcome for patients with advanced retinoblastoma, which is in accordance with data from other developing countries. Even though management of patients changed in accordance with changing standard of care over the decade, mortality remained high.

scholarly journals Liver abscess, management strategies, and outcome

2018 ◽  
Vol 5 (9) ◽  
pp. 3093
Author(s):  
Sudhir R. Jayakar ◽  
Prabhat B. Nichkaode
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Management Strategies ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Study Population ◽  
Set Up ◽  
Upper Abdominal ◽  
Diagnosis Therapy

Background: Liver abscess, a disease troubling mankind from ancient times, has earliest documentation in the Sanskrit document. Where right upper abdominal pain, have potentially lethal consequences, if prompt diagnosis and treatment are not accomplished. However, two major types are known, amoebic and pyogenic, in medical literature. Pyogenic liver abscess constitutes major bulk of hepatic abscess in western countries. The diagnosis is confirmed by ultrasonography, reddish brown (anchovy-paste like material) aspirate from abscess. The diagnosis, treatment and prognosis, of liver abscess have evolved remarkably over past few years. Imaging has improved diagnostic competence and has altered therapeutic strategy. The study aims at early clinical and  diagnosis on imaging of liver abscess, to set up some guide lines in view of conservative or either  intervention.Methods: The present study was hospital based longitudinal study, carried out in tertiary care teaching hospital from November 2013 to November 2015.  A total of 55 patients were enrolled in the study. All patients with suspicion of having liver abscess were confirmed on Imaging and included as present study population. Authors studied mainly presentation, role of conservative treatment, Aspiration, pigtail catheter, Outcome, and post procedural complications.Results: All patients presented with Pain right or left upper abdominal pain in abdomen, any chest complaints , majority of present study group patients had fever with or without rigors, deranged liver function. Imaging is the most diagnostic method, and also helped in therapy and follow up.Conclusions: Males are affected more than females, Imaging is the best modality for diagnosis, therapy and follow up. Aspiration or pigtail drainage is the standard method of drainage. Pigtail drainage is the better method of treatment than aspiration.

SEROPREVALENCE OF HIV AND HBsAg AMONGST BLOOD DONORS IN A TERTIARY CARE HOSPITAL, CHHATTISGARH.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Anusha P ◽  
Bankar Nandkishor J ◽  
Karan Jain ◽  
Ramdas Brahmane ◽  
Dhrubha Hari Chandi
Keyword(s):  
Hepatitis B ◽  
Blood Donors ◽  
Hepatitis B Surface Antigen ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Blood Bank ◽  
Care Hospital ◽  
Medical College ◽  
The World ◽  
First Time

INTRODUCTION: India being the second highly populated nation in the world. HIV/AIDS has acquired pandemic proportion in the world. Estimate by WHO for current infection rate in Asia. India has the third largest HIV epidemic in the world. HIV prevalence in the age group 15-49 yrs was an estimate of 0.2%. India has been classified as an intermediate in the Hepatitis B Virus (HBV) endemic (HBsAg carriage 2-7%) zone with the second largest global pool of chronic HBV infections. Safety assessment of the blood supply, the quality of screening measures and the risk of transfusion transmitted infectious diseases (TTIs) in any country can be estimated by scrutinizing the files of blood donors. After the introduction of the blood banks and improved storage facilities, it became more extensively used. Blood is one of the major sources of TTIs like hepatitis B, hepatitis C, HIV, syphilis, and many other blood borne diseases. Disclosure of these threats brought a dramatic change in attitude of physicians and patients about blood transfusion. The objective of this study is to determine the seroprevalence of transfusion transmitted infections amidst voluntary blood donors at a rural tertiary healthcare teaching hospital in Chhattisgarh. MATERIAL AND METHODS: This retrospective study was carried out in Chandulal Chandrakar Memorial Medical College, Kachandur, Durg. Blood donors were volunteers, or and commercial donors who donated the blood and paid by patients, their families, or friends to replace blood used or expected to be used for patients from the blood bank of the hospital. After proper donation of blood routine screening of blood was carried out according to standard protocol. Laboratory diagnosis of HIV 1 and HIV 2 was carried out by ELISA test. Hepatitis B surface antigen was screened by using ELISA. RESULTS: A total of 1915 consecutive blood donors’ sera were screened at Chandulal Chandrakar Memorial Medical College, blood bank during study period. Of these 1914 were male and 1 female. The mean age of patients was found to be 29.34 years with standard deviation (SD) of 11.65 Years. Among all blood donors in present study, 759(39.63%) were first time donors and 1156(60.37%) were repeated donors. 1 patient was HIV positive in first donation group while 3 (75%) were positive in repeat donation group. 7 (38.9%) were HBsAg positive in in first donation group while 11(61.1%) were positive in repeat donation group. Two patients in first donation group had dual infection of HIV and HBsAg. CONCLUSION: Seropositivity was high in repeated donors as compared to first time donors. The incidence of HIV is observed to be 0.2% and that of HBsAg is 0.94%. Strict selection of blood donors should be done to avoid transfusion-transmissible infections during the window period.

scholarly journals Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
United Arab Emirates ◽  
Liver Abscess ◽  
Hospital Admissions ◽  
Indian Subcontinent ◽  
Pyogenic Liver Abscess ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Liver Abscesses ◽  
Potential Risk Factors

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.

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