Clinical aspects of pyogenic liver abscess: the University Hospital of the West Indies experience.
Twenty-four cases of pyogenic liver abscess admitted between 1977 and 1986 are presented. A mean age of 43 years (range 5-78) with a 3:1 male:female ratio and 25% mortality were noted. Fever and abdominal pain were encountered in over 80% of cases and anorexia and malaise in over 60%. Hepatomegaly and right upper quadrant tenderness were the commonest signs. Leucocytosis, raised alkaline phosphatase and gamma-glutamyl transpeptidase, and hypoalbuminaemia were each noted in roughly 80% of cases. None of these showed any prognostic significance. Predisposing factors were noted in 11 cases. No cases of associated biliary disease were noted. Multiple, polymicrobial, aerobic and mixed aerobic/anaerobic abscesses were associated with a higher mortality. Patients aged over 50 years or more also had a higher mortality (P less than 0.05). Anaerobic abscesses were often solitary and were associated with a lower mortality (P less than 0.05). Surgical drainage and guided percutaneous drainage showed no difference in morbidity.
Bansal
A S
AS
Department of Microbiology, University Hospital of the West Indies, Kingston, Jamaica.
Prabhakar
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D007563:Jamaica; D008100:Liver Abscess / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013492:Suppuration