title: Epidemiology, Clinical Features and Outcome of Liver Abscess: A single Reference Center Experience in Qatar.
abstract: OBJECTIVE
  To describe the etiology, clinical presentation, management and outcome of liver abscess in adult patients admitted at Hamad general hospital, Qatar.
  
  
  METHODS
  A cross sectional study was conducted to involve all adult patients who sequentially encountered episodes of liver abscess during the period from January 1, 2009, to December 31, 2010. Blood cultures were drawn from all patients in the first 24 hours after admission. In addition, all patients had stool examinations and indirect Hemagglutination test for Entameba histolytica. Aspiration of abscess was done under CT guidance and aspirated pus was sent for gram stain and culture.
  
  
  RESULTS
  In total, 67 patients were admitted with liver abscess; 56 patients with pyogenic liver abscess and 11 with amebic liver abscess. There were 61 (91%) males and six (9%) females and their mean age was 47.4 ± 18.5 years. Fever, abdominal pain and vomiting were the commonest presenting features. Of the 56 pyogenic liver abscess patients, four discharged against medical advice and seven refused all invasive procedures and were treated with antibiotics for six weeks. The remaining 44 (79%) patients were treated with antibiotics and one or more invasive procedures, while one patient was treated surgically. The commonest organism isolated was Klebseilla pneumonia found in 21 patients (38%). The mean duration of hospitalization was 13.6 ± 8.1 days; the mean duration of antibiotic therapy was 34.7 ± 40.6 days, and one patient died. In contrast, all amebic liver abscess patients underwent ultrasound guided aspiration and showed good response to metronidazole treatment. Their mean duration of hospitalization was 7.7 ± 4.1 days, mean duration of therapy was 11.8 ± 2.1 days, and all patients were cured.
  
  
  CONCLUSIONS
  Pyogenic liver abscess was more common than amebic liver abscess with Klebseilla pneumonia being the commonest organism. With good medical measures and early drainage of liver abscess, surgical intervention was unnecessary in almost all the cases.
authors.affiliation: Consultant Physician, Department of Medicine, Hamad General Hospital, HMC, Doha, Qatar.
authors.forename: Mushtak Talib
authors.initials: MT
authors.lastname: Abbas
authors.affiliation: Consultant Physician, Department of Medicine, Hamad General Hospital, HMC, Doha, Qatar.
authors.forename: Fahmi Yousef
authors.initials: FY
authors.lastname: Khan
authors.affiliation: Resident, Department of Medicine, Weill Cornell Medical College, New York, USA.
authors.forename: Saif A
authors.initials: SA
authors.lastname: Muhsin
authors.affiliation: Specialist Internal Medicine, Alwakra health Center, Doha-Qatar.
authors.forename: Baidaa
authors.initials: B
authors.lastname: Al-Dehwe
authors.affiliation: Specialist infectious disease, Department of medicine, HMC, Doha, Qatar.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abukamar
authors.affiliation: Sr. Consultant of Medicine & Professor, Department of Medicine, Hamad General Hospital, P.O.Box 3050, Doha-Qatar.
authors.forename: Abdel-Naser
authors.initials: AN
authors.lastname: Elzouki
keywords: Amoebic abscess; Klebseilla pneumonia; Liver abscess; Pyogenic abscess