Pyogenic liver abscess: retrospective analysis of 80 cases over a 10-year period.
BACKGROUND
A total of 80 patients with pyogenic liver abscess managed at a single institution over a 10-year period were studied.


METHODS
The clinical features, laboratory, imaging, and microbiologic findings, management strategy, and final outcome were studied.


RESULTS
Fever and chills, leucocytosis and elevated alkaline phosphatase were the most common clinical and laboratory findings. Forty-one percent of patients were diabetic and 61% had biliary pathology. Systemic antibiotics and image-guided aspiration had a success rate of 94%. By multiple logistic regression analysis, malignancy on presentation (P = 0.011) was an independent risk factor associated with mortality. A past history of endoscopic sphincterotomy was an independent factor associated with resolution of liver abscess within 6 weeks (P = 0.03).


CONCLUSIONS
Pyrexia, leucocytosis, elevated alkaline phosphatase, presence of diabetes, and underlying biliary pathology are common clinical and laboratory findings in patients with pyogenic liver abscess. Malignancy was associated with a poor outcome. Previous endoscopic sphincterotomy was a good prognostic factor for early resolution.
Wong
Wai-Man
WM
University Department of Medicine, Queen Mary Hospital, University of Hong Kong, China. wmwongg@hku.hk
Wong
Benjamin Chun Yu
BC
Hui
Chee Kin
CK
Ng
Matthew
M
Lai
Kam Chuen
KC
Tso
Wai Kuen
WK
Lam
Shiu Kum
SK
Lai
Ching Lung
CL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015897:Comorbidity; D048909:Diabetes Complications; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008100:Liver Abscess / Q000382:microbiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents