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 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

SURGICAL SITE INFECTIONS; CULTURE & SENSITIVITY PATTERN OF MICRO-ORGANISMS ISOLATED IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 24 (01) ◽  
pp. 57-63
Author(s):  
Dr. Abdul Rashid Surahio ◽  
Dr. Altaf Ahmed Talpur ◽  
Dr Abdul Salam Memon ◽  
Prof. Afzal Junejo ◽  
Prof. Abdul Aziz Laghari
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Sensitivity Pattern ◽  
Culture Sensitivity ◽  
Micro Organisms

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 A study of microbial gamut and antibiograms in chronic suppurative otitis media

2018 ◽  
Vol 5 (1) ◽  
pp. 110
Author(s):  
Raj Tajamul Hussain ◽  
Sanam Altaf ◽  
Owais Makhdoomi ◽  
Mariya Ali
Keyword(s):  
Otitis Media ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Chronic Suppurative Otitis Media ◽  
Fungal Culture ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Suppurative Otitis Media ◽  
Gram Staining ◽  
Sensitivity Pattern

<p class="abstract"><strong>Background:</strong> The aim of the study was to discern the patterns in microbial diversity and the resistogram among the patients suffering from CSOM.</p><p class="abstract"><strong>Methods:</strong> A total number of 100 ear swabs were investigated for the present study. Their gram staining, direct microscopy with KOH, culture sensitivity, and biochemical tests were carried out to identify the organisms and to know their sensitivity pattern. All the swabs were collected from clinically diagnosed cases of chronic suppurative otitis media visiting otolaryngology outpatient department of tertiary care hospital. The study period was one year, from January 2016 to December 2017.  </p><p class="abstract"><strong>Results:</strong> Out of total 100 cases, 90 were culture<strong> </strong>positives, 6 showed no growth and 4 were<strong> </strong>skin contaminants (mirococci). Out of 90 culture positives, fungal culture was positive in 5 (5.5%) while combined bacteria and fungi obtained in 18 (20%) cases and only bacteria in 67 (74.4%) cases. Among the aerobic bacterial isolates, Pseudomonas aeruginosa was the most common bacteria isolated from the bacterial culture (n=36; 34.95%) followed by <em>Staphylococcus aureus </em>(n=28; 27.18%) and <em>Proteus</em> (n=13; 12.62%). Among the fungal isolates,<strong> </strong><em>Aspergillus niger </em>was predominant followed<strong> </strong>by Candida <em>albicans </em>&amp; <em>Aspergillus flavus.</em> Amikacin and imipenem were found to be the most effective antibiotics with low resistance rates.</p><p><strong>Conclusions:</strong> The present study gave an insight into the bacteriological profile of the cases of CSOM and their antibiotic sensitivity patterns. This in turn will ensure rational and judicious use of antibiotics and thus prevent emergence of resistant bugs and also the complications associated with CSOM.</p>

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 profile of amoebic liver abscess patients admitted in a tertiary care hospital

2016 ◽  
Vol 48 (1-2) ◽  
pp. 20-23 ◽  
Author(s):  
Bishnupada Paik ◽  
Swapan Kumar Sarkar ◽  
Poritosh Kumar Chowdhury ◽  
Saad Ahmed
Keyword(s):  
Clinical Features ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Clinical Profile ◽  
Amoebic Liver Abscess ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
The Mean

Amoebic liver abscess is an important cause of space occupying lesions of the liver, especially in tropical and sub tropical regions. It is the most frequent complication of invasive amebiasis. It may be found in all age groups but relatively rare in children. The signs and symptoms vary according to the severity of illness. The present study was done to evaluate the clinical profile of patients with amoebic liver abscess for age, gender, clinical features, site of abscess, number of abscess, treatment modality by intravenous metronidazole along with percutaneous needle aspiration and prognosis. A prospective study of 86 admitted patients of amoebic liver abscess were included in this study which was carried out in the medicine department of Khulna Medical College Hospital over a period of 2 years from July 2010 to June 2012. Mean age of patients was 45 years. Male female ratio was 7:1. The mean duration of fever was 17.9 days and the mean duration of pain was 14.1 days. The duration of fever for more than 2 weeks was seen in 38 cases. Regarding clinical features, the major symptoms of fever, pain abdomen and dysentery were seen in 81, 78 and 10 cases respectively. The major signs as determined by clinical and radio imaging studies were hepatomegaly in 76, right lobe abscess in 60, left lobe abscess in 12, multiple abscesses in both lobes in 18, ascites in 5 and right sided pleural effusion in 12 cases respectively. All the cases underwent percutaneous needle aspiration. 5 cases died out of 86 patients.Bang Med J (Khulna) 2015; 48 : 20-23

Antimicrobial culture sensitivity pattern in neonatal sepsis in a tertiary-care hospital

2016 ◽  
Vol 5 (4) ◽  
pp. 661 ◽  
Author(s):  
Hardik Vaniya ◽  
Nirav Patel ◽  
Jitendra Agrawal ◽  
Hiren Trivedi ◽  
Jatin Dhanani ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Sensitivity Pattern ◽  
Culture Sensitivity

scholarly journals Effective treatment options in amoebic liver abscess in a tertiary care setting in West Bengal: an observational study, India

2018 ◽  
Vol 5 (11) ◽  
pp. 3666
Author(s):  
Ankan Mondal ◽  
Arista Lahiri ◽  
Prama Ray ◽  
Atanu Bhattacharjee
Keyword(s):  
Observational Study ◽  
Liver Abscess ◽  
Treatment Options ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Amoebic Liver Abscess ◽  
Percutaneous Catheter Drainage ◽  
Care Hospital ◽  
Open Drainage ◽  
Catheter Drainage

Background: Conservative management and image guided drainage have emerged as mainstay of the treatment in Amoebic Liver Abscess (ALA), with surgery used in complicated cases. The current study was conducted with an objective to demonstrate the effectiveness of the different treatment options in ALA.Methods: An observational study was conducted on 100 patients, aged 19 to 60 years, admitted with sonographic evidence of Amoebic Liver Abscess (ALA) in the General Surgery wards of a tertiary care hospital in Kolkata. Patients coming for regular follow-up after completing treatment were included. On completion of the treatment before discharge a repeat ultrasonography of the upper abdomen was done to confirm remission.Results: Majority of the patients were male, Muslim, rural resident and within 30 – 40 years age. Chief complaints were pain (100%), fever (60%) and abdominal swelling (80%). Tender hepatomegaly (80%) and icterus (36%) were present. Majority patients had the left lobe of the liver affected (72%) and abscess dimension <6 cms (66.67%). Out of the participants with unruptured abscess 21.87% had multiple abscesses. Out of 64 patients subjected to conservative therapy, 44 were successfully managed. Success rate of 72.73% was observed among 44 patients receiving ultrasound guided needle aspiration. All twenty patients subjected for pigtail catheter drainage were cured. Four patients underwent laparotomy and open drainage following intraperitoneal rupture.Conclusions: Conservative treatment was observed to be sufficient in majority of cases of amoebic liver abscess of lesser size with percutaneous catheter drainage useful in large abscess. Surgical intervention was required in ruptured or complicated abscesses. 

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