Medical treatment of multiple streptococcal liver abscesses.
We describe four cases of multiple, cryptogenic, and streptococcal liver abscesses which were cured with antibiotic therapy. Two of the patients were referred for medical management as a last resort after open surgical drainage failed to eradicate the suppurative process. The other two patients were treated from the time of diagnosis with antimicrobial agents alone. Blood cultures or needle aspirates of the abscesses yielded a pure growth of streptococci in all instances. All isolates were susceptible to penicillin G. Cryptogenic streptococcal abscesses may represent a subset of multiple hepatic abscesses particularly amenable to successful medical therapy consisting of a minimum of 6 weeks parenteral antibiotic therapy followed by a period of oral antibiotics until clinical, biochemical, and radiological resolution of the abscesses has occurred.
D000328:Adult; D001707:Biopsy, Needle; D002701:Chloramphenicol / Q000627:therapeutic use; D004322:Drainage; D005243:Feces / Q000382:microbiology; D005260:Female; D006529:Hepatomegaly / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008100:Liver Abscess / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use*; D011859:Radiography; D011877:Radionuclide Imaging; D012480:Salmonella Infections / Q000150:complications; D012486:Salmonella typhimurium / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy*; D013291:Streptococcus / Q000302:isolation & purification; D013455:Sulfur; D013667:Technetium; D013671:Technetium Tc 99m Sulfur Colloid
D013671:Technetium Tc 99m Sulfur Colloid; D002701:Chloramphenicol; D013455:Sulfur; D013667:Technetium; D010400:Penicillin G