Pyogenic liver abscess: Retrospective analysis of 80 cases over a 10-year period

• Published in: Journal of gastroenterology and hepatology 2002-09, Vol.17 (9), p.1001-1007
• Main Authors: Wong, Wai-Man, Wong, Benjamin Chun Yu, Hui, Chee Kin, Ng, Matthew, Lai, Kam Chuen, Tso, Wai Kuen, Lam, Shiu Kum, Lai, Ching Lung
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; biliary pathology; Biological and medical sciences; Comorbidity; Diabetes Complications; diabetes mellitus; Female; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - mortality; Gram-Negative Bacterial Infections - pathology; Gram-Negative Bacterial Infections - therapy; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - mortality; Gram-Positive Bacterial Infections - pathology; Gram-Positive Bacterial Infections - therapy; Human bacterial diseases; Humans; Infectious diseases; Liver Abscess - microbiology; Liver Abscess - mortality; Liver Abscess - pathology; Liver Abscess - therapy; Male; malignancy; Medical sciences; Middle Aged; pyogenic liver abscess; Retrospective Studies; Risk Factors; risk factors for mortality; Survival Rate; Treatment Outcome
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1046/j.1440-1746.2002.02787.x

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). Conclusion: 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. © 2002 Blackwell Publishing Asia Pty Ltd