Pyogenic hepatic abscess. A 10-year population-based retrospective study

• Published in: APMIS : acta pathologica, microbiologica et immunologica Scandinavica Vol. 106; no. 1-6; pp. 396 - 402
• Main Authors: HANSEN, PER SYRAK, SCHØNHEYDER, HENRIK CARL
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-1998; Blackwell
• Subjects: abscess; Adolescent; Adult; Aged; Aged, 80 and over; Bacteria - isolation & purification; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Child; Female; follow-up; Follow-Up Studies; Human bacterial diseases; Humans; Infectious diseases; Liver; Liver Abscess - diagnosis; Liver Abscess - microbiology; Liver Abscess - therapy; Male; Medical sciences; microbiology; Middle Aged; Retrospective Studies; therapy; Denmark; Europe; Human; Prognosis; Liver; Abscess; Hepatic disease; Epidemiology; Incidence; Infection; Pyogenic; Treatment; Etiology; Bacteriosis; Digestive diseases; Public health
• ISSN: 0903-4641; 1600-0463
• DOI: 10.1111/j.1699-0463.1998.tb01363.x

A 10‐year retrospective survey was undertaken of patients with pyogenic hepatic abscesses (PHA). Fifty‐two patients fulfilled the criteria of PHA, equivalent to a mean annual incidence of 11/1,000,000. The main symptom was fever. Laboratory tests were compatible with infection, slightly elevated alkaline phosphatase being the only test pointing towards the liver as the focus of infection. Forty‐one patients (79%, 95% CL, 68–90%) had positive cultures from aspirated pus, with a total of 79 isolates. Enteric Gram‐negative rods accounted for 45% and anaerobic bacteria for 31% of PHA isolates. Gram‐positive cocci, predominantly non‐haemolytic streptococci, were the third largest group (19%), but were rare among blood isolates. Positive blood cultures were found in 21 patients (40%, 95% CL, 27–54%), with a total of 28 isolates. Percutaneous drainage was performed in 26, percutaneous needle aspiration in 10, combinations thereof in 5, and abdominal surgery in 5. Forty‐nine patients received systemic antibiotic therapy, four of whom were treated with antibiotics only. Seven recurrences occurred and the overall case fatality rate was 6% (95%, CL 0–12%), which might reflect a low rate of underlying malignant diseases in our study material.