Liver abscess in Western Australia (1974-1983).
Over the 10 year period 1974-1983, 91 cases of liver abscess presented to the major teaching hospitals in Perth, Western Australia. Amoebic liver abscess (ALA) accounted for 37 (or 41%) of these cases, an incidence inflated by Perth's proximity to south-east Asia where amoebiasis is endemic. This frequent recent history of contact, the availability of sensitive and specific diagnostic serology and a clinical presentation usually suggesting pathology in the right upper quadrant, accounted for the consistently short delay in diagnosis of ALA. There were no deaths from ALA and a low incidence of complications such as secondary infection or rupture into the thorax. On the other hand, pyogenic liver abscess (PLA) commonly presented in a more non-specific manner and in an older age group, contributing to a long delay in diagnosis. Despite improvements in liver imaging techniques and advances in antibiotic and general supportive therapy, mortality for PLA remains high, 20% in this series. Fatal PLA was associated with multiple abscesses not amenable to drainage, increasing age, delay in diagnosis and the presence of septicaemia.
Levitt
M D
MD
Quinlan
M F
MF
Sheiner
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000563:Amebicides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia; D002648:Child; D004322:Drainage; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology / Q000628:therapy; D008101:Liver Abscess, Amebic / Q000175:diagnosis / Q000469:parasitology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence
D000563:Amebicides; D000900:Anti-Bacterial Agents