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 CLINICAL PROFILE AND MANAGEMENT OF PATIENTS OF AMOEBIC LIVER ABSCESS IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 5-7
Author(s):  
Rakesh Mishra ◽  
Debabrata Banerjee ◽  
Debarshi Jana
Keyword(s):  
Drug Treatment ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Needle Aspiration ◽  
Intestinal Disease ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Early Recovery

Introduction: Amoebiasis is caused by the protozoan Entamoeba histolytica. Most infections are asymptomatic; clinical manifestations include amoebic dysentery and extra intestinal disease. Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis. Amoebae establish hepatic infection by ascending the portal venous system. Aim: To study various aspects of Amoebic Liver Abscess like demographic profiles, clinical presentations, association with intestinal disease, radiological and laboratory findings, treatment modalities and complications. Materials and Methods: A hospital based prospective observational study was performed in the Department of Internal Medicine, Command Hospital (Eastern Command), Kolkata, from Jan 2018 to Jun 2019. All confirmed cases of amoebic liver abscess above the age of 18 years admitted in Command Hospital (EC) were included in this study. The patient were then subsequently followed up for 01 year with USG abdomen every 03 monthly. Results: Total 40 patients of Amoebic Liver Abscess with age more than 18 year were enrolled in the study. The age ranged from 26 to 70 years (mean age 46.2 year). Male patients were dominated over female. 80.0 % were from rural background. About 55% patients were addicted to alcohol & 25.0 % were known diabetics at presentation. In all, 07 (17.5%) patients with abscess size of 6 cm to 10 cm (Vol> 300 cc) were treated by needle aspiration and drug therapy. Remaining 17(42.5%) patients with abscess size more than 10 cm were treated with pigtail drainage and drug. Conclusion: There is significant advantage of pigtail drainage with drug treatment over needle aspiration with drug and only with drug treatment in terms of decrease in lesion size and early recovery.

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.

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

CLINICAL AND BIOCHEMICAL PROFILE OF LIVER ABSCESS PATIENTS AT MEDICINE DEPARTMENT OF ANMMCH, GAYA, BIHAR

2021 ◽  
pp. 30-32
Author(s):  
Bharat Bhushan ◽  
Debarshi Jana
Keyword(s):  
Diabetes Mellitus ◽  
Liver Abscess ◽  
Cost Effective ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Medicine Department ◽  
Male Preponderance ◽  
Right Lobe ◽  
Inadequate Nutrition ◽  
Upper Abdomen

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

Clinical and biochemical profile of liver abscess patients

2017 ◽  
Vol 5 (6) ◽  
pp. 2596 ◽  
Author(s):  
Vineet Jain ◽  
Smita Manjavkar ◽  
Prem Kapur ◽  
. Durfishan ◽  
Divya Rajput ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Liver Abscess ◽  
Cost Effective ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Biochemical Profile ◽  
Male Preponderance ◽  
Right Lobe ◽  
Inadequate Nutrition ◽  
Upper Abdomen

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.

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 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.

scholarly journals A clinical study of liver abscess in patients attending the surgical department. A single center experience.

2021 ◽  
pp. 7-10
Keyword(s):  
Liver Abscess ◽  
Tamil Nadu ◽  
Complete Blood Count ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
College Hospital ◽  
X Ray ◽  
Surgical Department

Liver abscess is a condition that is seen by surgeons all over the world. The patients present to the surgical department with features of right hypocondrial pain, fever and jaundice. Investigations such as ultrasound of the abdomen and CT scan of the abdomen are extremely useful in diagnosing a case of liver abscess. The two main causes of liver abscess are amoebic and pyogenic liver abscess. Occasionally a liver abscess may also occur due to fungal infection. Treatment modalities include the use of drugs such as metronidazole for amoebic liver abscess, as well as needle aspiration and pigtail catheter drainage when required. This was a prospective study was carried out from August 2015 to July 2018, for a period of three years. The study was conducted at SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India. Investigations such as complete blood count (CBC), chest x-ray, x-ray abdomen, ultrasound of the abdomen and CECT of the abdomen were done. A total of 57 patients were studied and the results obtained were analysed.

scholarly journals Comparison between supra-cath and pigtail in drainage of liver abscess

2017 ◽  
Vol 4 (8) ◽  
pp. 2689
Author(s):  
Poonam Gupta ◽  
Anubhav Goel ◽  
Rajesh Kumar
Keyword(s):  
Liver Abscess ◽  
Percutaneous Drainage ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Amoebic Liver Abscess ◽  
Care Centre ◽  
Percutaneous Aspiration ◽  
Tertiary Care Centre ◽  
Average Size

Background: A majority of patients with liver abscess respond rapidly to treatment with drugs but the remaining specially with complications will eventually require either percutaneous aspiration or percutaneous drainage for their resolution. For this, Ryle’s tubes and Pigtail catheters have been used for percutaneous drainage of abscess. Supra-Cath is the latest variety of catheter which can be used for this purpose. Our study compares supracath and pigtail application for management.Methods: We conducted a prospective randomized comparative study in the departments of Surgery and Radiology, UPUMS Saifai, Etawah, Uttar Pradesh. A rural tertiary care centre in total of 60 patients from August 2016 to April 2017.Results: Average age in PCD and SCD were 38 and 42 respectably. Male:female ratio was 23:7 in PCD group and 21:9 in SCD group. Average size of abscess was 6.7 cm in PCD group and 6.9 in SCD group. Amoebic liver abscess was 18 in PCD and 22 in SCD group. Pyogenic abscess was 12 in PCD and 8 in SCD group. Average time for removal of PCD was 9.7 days and 8.6 in SCD group. In follow, up six patient had residual abscess in PCD group and two in SCD group at one month interval and all resolved with conservative treatment.Conclusions: Supra-Cath is very useful catheter for effective and safe drainage of large liver abscess and can be used as an alternative to pigtail catheter if not available.

scholarly journals Association of blood culture with carbapenem use in pyogenic liver abscess: a two-center retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuangjun He ◽  
Jie Yu ◽  
Hairong Wang ◽  
Lifeng Wang ◽  
Yi Chen ◽  
...  
Keyword(s):  
Blood Culture ◽  
Liver Abscess ◽  
Bacterial Culture ◽  
Multivariate Analyses ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Extended Spectrum Beta Lactamase ◽  
Tertiary Care Centers ◽  
High Positivity Rate ◽  
Positive Results

Abstract Background Highly empiric use of carbapenem in pyogenic liver abscess (PLA) is widespread problem. However, few studies have examined the association between blood culture and carbapenem use in patients with PLA in China. Thus, we conducted this observational study. Methods The data of patients diagnosed with PLA at two comprehensive tertiary care centers from 2014 to 2020 were retrospectively collected. Demographic and clinical data were analyzed, and univariate and multivariate analyses were performed to investigate the association between blood culture and carbapenem use. Subgroup analysis was conducted to explore whether the effect is different in sepsis. Results Blood culture was performed in 110 (46.0%) patients, of whom 44 (40.0%) patients had positive results for bacterial culture. Extended-spectrum beta-lactamase (ESBL)-positive blood culture isolates were detected in 8 (7.3%) patients. The positivity rate of blood culture in sepsis was higher than in non-sepsis (58.1% vs. 32.9%, P = 0.015). Fewer patients who had a blood culture received carbapenem treatment in comparison to patients without blood culture (19.1% vs. 31.8%, P = 0.026). Multivariate analysis showed that blood culture was independently associated with less carbapenem exposure (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.16–0.68, P = 0.003), and this effect remained significant in the sepsis subgroup (adjusted OR = 0.17, 95% CI: 0.05–0.53, P = 0.002). Conclusion Blood culture had a high positivity rate and was associated with less carbapenem use in PLA, especially those who developed sepsis. More attention should be paid to performing early blood culture and less carbapenem use in PLA.

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