[Presentation, diagnosis and treatment of pyogenic liver abscess: analysis of a series of 63 cases].
BACKGROUND
The aim of this study was to know the clinical, etiopathogenic and microbiologic characteristics of pyogenic liver abscesses (PLA).


METHODS
A retrospective analysis of the cases of PLA diagnosed from 1978 to 1992 in the Internal Medicine, Infectious Disease, and Gastrointestinal Surgery Departments of the Hospital de Bellvitge in Barcelona, Spain was performed.


RESULTS
A total of 63 cases of PLA (43 males and 20 females, mean age 54 +/- 19 years) were analyzed. The most frequent clinical and analytical data included fever (92%), leucocytosis (84%) and abnormal levels of alkaline phosphatase (81%). The PLA were single in 65% and multiple in 35%. Echography was diagnostic in 91% of the cases. A positive culture of the abscess was obtained in 40 cases, being monomicrobial in 27 cases (67.5%). Eleven of the 13 polymicrobial cultures were from single PLA. The most frequent bacteria found were the enterobacteria (44%) followed by the microaerophilic streptococci (28%) and the anaerobes (17%). The PLA was of biliary origin in 31.8%, contiguous in 12.7% and unknown in 38%. Percutaneous drainage was performed in 34 patients (54%). Mortality attributable to the abscess was 3%.


CONCLUSIONS
The clinical presentation of pyogenic liver abscess has not varied over time. There has, however, been a change with respect to its epidemiology and therapeutic management. At present, the possibility of rapid diagnosis and image guided percutaneous drainage offers a better prognosis for this disease.
Corbella
X
X
Servicio de Medicina Interna, Hospital de Bellvitge, Universitat de Barcelona.
Vadillo
M
M
Torras
J
J
Pujol
M
M
Rafecas
A
A
Gudiol
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D004322:Drainage; D005260:Female; D006801:Humans; D015994:Incidence; D008100:Liver Abscess / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
D000900:Anti-Bacterial Agents
Presentación, diagnóstico y tratamiento del absceso hepático piógeno: análisis de una serie de 63 casos.