Incidence and Risk Factors for Liver Abscess After Thermal Ablation of Liver Neoplasm

El absceso hepático es un reto diagnóstico y terapéutico. Es una patología poco frecuente en la niñez que predomina en países en desarrollo y se asocia a malnutrición y parasitosis. El absceso hepático piógeno es el más frecuente, es una causa de hospitalización prolongada por el requerimiento de antimicrobianos endovenosos; usualmente con baja mortalidad.A continuación, presentamos una serie de cuatro casos clínicos de pacientes con abscesos hepáticos piógenos que fueron manejados entre el 2016 y 2018 en el Hospital de Especialidades Pediátricas.Tres pacientes fueron del sexo femenino y uno masculino. En dos de los pacientes se identi có factor predisponente: diabetes mellitus e infección avanzada por VIH. Los síntomas más frecuentes fueron ebre (100%), dolor abdominal (100%) y hepatomegalia (50%). En ninguno de los casos se sospechó absceso hepático a su ingreso. Los casos fueron diagnosticados por sonograma hepático y corroborados con tomografía abdominal. El tamaño promedio de las lesiones fue de 6.88 x 6.18 x 6.12 cm. Tres fueron de localización derecha y uno de localización izquierda. Todos los pacientes recibieron antibioticoterapia de amplio espectro y drenaje percutáneo. Se identi có agente etiológico en uno de los pacientes: Staphylococcus aureus.Los pacientes recibieron una media de 33 + 3.5 días de tratamiento. Con evolución favorable en todos los casos y mejoría en seguimiento con ultrasonidos. Ningún paciente requirió intervención quirúrgica. Abstract The liver abscess involves an authentic diagnostic and therapeutic challenge. It is not frecuent in childhood. Occurs mainly in developing countries and is associated to malnutrition and parasitic infection, that are described as risk factors. Pyogenic liver abscess represents, in most of the cases, a cause of long-time hospitalizations because of the requirement of endovenous treatment, but usually with low mortality.We describe a four-case series of patients with pyogenic liver abscess between 2016 and 2018 in Hospital de Especialidades Pediatricas in Panamá City.Three patients were female and one was a male. In two of the cases, there were risk factors such as diabetes mellitus and advanced HIV infection.The most frequent symptoms were: fever (100%), abdominal pain (100%) and hepatomegaly (50%).In neither one of the cases, liver abscess was suspected as diagnosis. All cases were diagnosed by hepatic sonogram and con rmed by abdominal CT- scan. The mean size of lesions was 6.88 x 6.18 x 6.12 cm. Three of the cases were located in right lobe and one in the left lobe of the liver. They were managed with broad-spectrum antibiotics and percutaneous drainage.Staphylococcus aureus was isolated in one case.The patients received a mean of 33 + 3.5 days of treatment. All cases evolved well with improvement of lesion in ultrasonography. None of the patients required surgical intervention.

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Evaluation of clinical risk factors for developing pleural empyema secondary to liver abscess

BMC Gastroenterology ◽

10.1186/s12876-019-1128-4 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Eunjue Yi ◽

Tae Hyung Kim ◽

Jun Hee Lee ◽

Jae Ho Chung ◽

Sungho Lee

Keyword(s):

Risk Factors ◽

Pleural Effusion ◽

Liver Abscess ◽

Biliary Tract ◽

Clinical Manifestation ◽

Pyogenic Liver Abscess ◽

Pleural Empyema ◽

Patient Characteristics ◽

Group 2 ◽

The Right

Abstract Background The aim of this study was to investigate the clinical manifestation and predictive risk factors of pleural empyema developing during treatment of the pyogenic liver abscess. Methods Medical records of patients with the liver abscess in our institution were reviewed retrospectively. Enrolled patients were classified into four groups; Group 1: patients without pleural effusion, Group 2: patients with pleural effusion and who were treated noninvasively, Group 3: patient with pleural effusion and who were treated with thoracentesis, and Group 4: patients with pleural effusion that developed into empyema. Patient characteristics, clinical manifestation, and possible risk factors in development of empyema were analyzed. Results A total of 234 patients was enrolled in this study. The incidence rate of empyema was 4.27% (10 patients). The mean interval for developing pleural effusion was 5.6 ± 6.35 days. In multivariate analysis, risk factors for developing pleural effusion included the location of the liver abscess near the right diaphragm (segment 7 and 8, OR = 2.30, p = 0.048), and larger diameter of the liver abscess (OR = 1.02, p = 0.042). Among patients who developed pleural effusions, presences of mixed microorganisms from culture of liver aspirates (OR = 10.62, p = 0.044), bilateral pleural effusion (OR = 46.72, p = 0.012) and combined biliary tract inflammation (OR = 21.05, p = 0.040) were significantly associated with the need for invasive intervention including surgery on effusion. Conclusion The location of the liver abscess as well as pleural effusion, elevated inflammatory markers, and combined biliary tract inflammation may be important markers of developing pleural complication in patients with pyogenic liver abscess.

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Liver Abscess After Transarterial Chemoembolization in Patients With Bilioenteric Anastomosis: Frequency and Risk Factors

American Journal of Roentgenology ◽

10.2214/ajr.12.9630 ◽

2013 ◽

Vol 200 (6) ◽

pp. 1370-1377 ◽

Cited By ~ 52

Author(s):

Sungmin Woo ◽

Jin Wook Chung ◽

Saebeom Hur ◽

Seung-Moon Joo ◽

Hyo-Cheol Kim ◽

...

Keyword(s):

Risk Factors ◽

Liver Abscess ◽

Transarterial Chemoembolization ◽

Bilioenteric Anastomosis

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Mortality Risk Factors in Patients with Pyogenic Liver Abscess

10.47829/cos.2021.5903 ◽

2021 ◽

Vol 05 (09) ◽

Author(s):

dos Santos-Rosa OM ◽

dos Santos RLC ◽

Favaro ML ◽

Fonseca AZ ◽

Junior MAFR

Keyword(s):

Risk Factors ◽

Liver Abscess ◽

Mortality Risk ◽

Pyogenic Liver Abscess

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Risk Factors, Management, and Outcomes of Pyogenic Liver Abscess in a US Safety Net Hospital

Digestive Diseases and Sciences ◽

10.1007/s10620-019-05851-9 ◽

2019 ◽

Vol 65 (5) ◽

pp. 1529-1538 ◽

Cited By ~ 3

Author(s):

V. V. P. K. Mukthinuthalapati ◽

Bashar M. Attar ◽

L. Parra-Rodriguez ◽

Nicolo L. Cabrera ◽

Tiago Araujo ◽

...

Keyword(s):

Risk Factors ◽

Liver Abscess ◽

Pyogenic Liver Abscess ◽

Safety Net ◽

Safety Net Hospital

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Pyogenic Liver Abscess Following Pancreaticoduodenectomy: Risk Factors, Treatment, and Long-Term Outcome

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-014-2466-8 ◽

2014 ◽

Vol 18 (5) ◽

pp. 922-928 ◽

Cited By ~ 11

Author(s):

Victor C. Njoku ◽

Thomas J. Howard ◽

Changyu Shen ◽

Nicholas J. Zyromski ◽

C. Max Schmidt ◽

...

Keyword(s):

Risk Factors ◽

Liver Abscess ◽

Pyogenic Liver Abscess ◽

Term Outcome ◽

Long Term Outcome

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Risk factors for spontaneous rupture of liver abscess caused by Klebsiella pneumoniae

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2004.12.016 ◽

2005 ◽

Vol 52 (2) ◽

pp. 79-84 ◽

Cited By ~ 27

Author(s):

Chen-Hsiang Lee ◽

Hsieh-Shong Leu ◽

Ting-Shu Wu ◽

Lin-Hui Su ◽

Jien-Wei Liu

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Spontaneous Rupture

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3-in-1: bilateral subcutaneous leg abscesses and liver abscess from Klebsiella pneumoniae

BMJ Case Reports ◽

10.1136/bcr-2020-235926 ◽

2020 ◽

Vol 13 (9) ◽

pp. e235926

Author(s):

Mark Anthony Santiago Sandoval ◽

Ma Carrissa Abigail Roxas ◽

Maria Sonia Salamat ◽

Jarold Pauig ◽

Irewin Tabu ◽

...

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Virulence Genes ◽

Unusual Case ◽

Ballet Dancer ◽

Capsular Type ◽

Leg Muscles ◽

Liver Abscesses ◽

Increased Blood Flow

Hypervirulent strains of Klebsiella pneumoniae are known to cause liver abscesses and other metastatic infections. Being Asian and having diabetes are known host risk factors. Here we present an unusual case of a Filipino ballet dancer–choreographer with diabetes presenting with bilateral leg pains initially thought to be cellulitis, but was eventually diagnosed as bilateral subcutaneous leg abscesses. He also had a liver abscess, thankfully asymptomatic, which was only discovered on imaging. The occurrence of three distant abscesses in one patient, hence ‘3-in-1,’ makes this case worth reporting. Bilateral subcutaneous leg abscesses as the presenting manifestation of this infection have not been reported yet. We hypothesise that his occupation which makes use of frequent contractions of leg muscles led to increased blood flow and preferentially directed blood-borne bacteria to localise in both legs. We have also characterised the pathogen with regards to its hypermucoviscous phenotype, capsular type, virulence genes and phylogeny.

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