Pyogenic liver abscess: Clinical features and microbiological profiles in tertiary care center

• Published in: Journal of family medicine and primary care 2020-08, Vol.9 (8), p.4337-4342
• Main Authors: Kumar, Shyam, Perween, Naz, Omar, Balram, Kothari, Ashish, Satsangi, Akash, Jha, Mithilesh, Mohanty, Aroop
• Format: Article
• Language: English
• Subjects: anaerobe; Antibacterial agents; Enzyme-linked immunosorbent assay; Health aspects; Infection; Liver diseases; Microbiology; Original; pyogenic liver abscess; right lobe
• ISSN: 2249-4863; 2278-7135
• DOI: 10.4103/jfmpc.jfmpc_927_20

Background: Pyogenic liver abscess (PLA) is the end result of a number of pathologic processes that cause a suppurative infection of the liver parenchyma. Materials and Methods: Sixty-five patients of age more than 18 years and radiologically confirmed cases of liver abscess were included in this study. Pus and blood samples were collected. Pus was processed for microscopy of trophozoite of Entamoeba histolytica and aerobic and anaerobic bacterial culture. Blood was processed for antibody ELISA for Entamoeba histolytica and aerobic bacterial culture. Identification of aerobic and anaerobic isolates was done by Vitek2 and antibiotic sensitivity test for aerobic bacterial isolates was done by Vitek2. Result: Out of sixty five, twenty five were confirmed as PLA. All patients were male with mean age 37.9 years. Fever and upper abdominal pain were the most common symptoms. Right lobe comprised 80% of the abscess. Pus sample was more sensitive than blood sample for diagnosis. There were a total of 33 isolates in our study. Klebsiella pneumoniae (6/33) was the most common aerobic isolate and Clostridium spp. (7/33) was the anaerobic isolate. All gram-negative bacteria were showing good sensitivity for 3rd and 4th generation cephalosporins, fluoroquinolones, amikacin, gentamicin, piperacillin-tazobactam, imipenem and meropenem. Abscess >5 cm was treated with percutaneous drainage while abscess