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PubMed1978

Amebic peritonitis following rupture of an amebic liver abscess. Successful treatment of two patients.

We present two successfully treated cases of amebic peritonitis. Acute peritonitis secondary to intra-abdominal rupture of an amebic liver abscess is an infrequent but serious complication of invasive amebiasis. Its diagnosis should be considered in anyone with a suspected liver abscess, jaundice, or diarrhea in whom peritonitis develops. This diagnosis should be further suggested in the United States if the patient is a male and is of Mexican origin in areas where this racial group constitutes the majority of cases of amebic disease. Use of radioisotope liver scans and the demonstration of serum precipitins to Endamoeba histolytica may provide rapid evidence of invasive disease, although surgical intervention is often necessary to make a specific diagnosis. Emetine hydrochloride alone or followed by metronidazole combined with surgical drainage is the current treatment for amebic peritonitis.

Adult↗
PubMedDate not supplied

[Pyogenic liver abscess and schistosomiasis mansoni in the state of Espírito Santo].

A possible association of the acute toxemic form of schistosomiasis and pyogenic liver abscess (PLA) has been recently suggested. As in the west of the Espírito Santo state schistosomiasis is endemic and PLA are frequently diagnosed in the Children's Hospital of Vitória we reviewed the records of the Hospital during the period from May 1991 to April 1993 to: a) identify all cases of PLA in which Schistosoma mansoni infection was present and b) annotate the procedence of each case to verify if there is an association of the two diseases. 65 cases of PLA were recorded and 39 had the result of a stool examination, being three positive for Schistosoma mansoni (7.6%) and 26 for other helminth (mainly Ascaris and Trichocephalus). The procedence of the patients showed that only 7 (10.7%) came from endemic areas. These results show that an association of Schistosoma mansoni infection and PLA was not significative in the country, where the acute toxemic form is not frequent. The great majority of PLA in this study came from the urban periphery of Vitória, where transmission of schistosomiasis does not occur but intestinal helminth infections are extremely frequent. The great majority of PLA in this study came from the urban periphery of Vitória, where transmission of schistosomiasis does not occur but intestinal helminth infections are extremely frequent. As 40% of these PLA were cryptogenetic it is possible that the immunomodulation induced by intestinal parasites and the liver granulomas produced by the larvae of these helminths would be predisposing factors for pyogenic liver abscess.

Animals↗
PubMed1995

Gas-forming liver abscess following transcatheter hepatic arterial embolization for an iatrogenic intrahepatic pseudoaneurysm: report of a case.

We herein describe a case of gas-forming pyogenic liver abscess following transcatheter hepatic arterial embolization (THAE) for an iatrogenic intrahepatic pseudoaneurysm in a 74-year-old woman. Hemobilia developed 19 days after percutaneous transhepatic cholangio-drainage was performed for the purpose of percutaneous cholangioscopic lithotripsy for the treatment of post-gastrectomy choledocholithiasis. Celiac arteriography disclosed a saccular aneurysm in the right hepatic artery. The pseudoaneurysm was successfully occluded by THAE with gelatin powder and a stainless steel coil of the Gianturco type. Ten days after successful THAE, abdominal computed tomography revealed a gas-containing cavity, which suggested the presence of a gas-forming abscess, in the posterior hepatic segment, and percutaneous transhepatic abscess drainage was performed. Thus, impaired hepatic perfusion following effective THAE and coexisting cholangitis may play an important role in the development of a gas-forming pyogenic liver abscess.

Aged↗
PubMed1990

Pyogenic liver abscess: clinical manifestations and value of percutaneous catheter drainage treatment.

One hundred and sixty-two patients with solitary or multiple pyogenic liver abscesses received surgical or medical treatment in the past 8 years. Fifty-seven patients were treated medically (medical group), 62 patients received medical treatment plus sonogram-guided percutaneous drainage (PCD group), and 43 patients received surgical drainage (surgical group). Aerobic gram-negative rods were the predominant causative microorganisms. Klebsiella pneumoniae was the most common microorganism, occurring in 46.9% (76/162) of the cases. Anaerobes occurred in 16.7% (27/162) of the cases. In the evaluation of treatment, the success rates for these three groups were: medical group, 59.6% (34/57); PCD group, 90.3% (56/62); and surgical group, 83.7% (36/43). This retrospective study confirms evidence from a small series that medical treatment plus percutaneous catheter drainage is efficient and more convenient than conventional surgical drainage for pyogenic liver abscesses. The frequent severe septic emboli to distant organs noted in this series (11.1%; 18/162) are quite unusual and should be anticipated in the future.

Adult↗
PubMed1983

Medical treatment of multiple streptococcal liver abscesses.

We describe four cases of multiple, cryptogenic, and streptococcal liver abscesses which were cured with antibiotic therapy. Two of the patients were referred for medical management as a last resort after open surgical drainage failed to eradicate the suppurative process. The other two patients were treated from the time of diagnosis with antimicrobial agents alone. Blood cultures or needle aspirates of the abscesses yielded a pure growth of streptococci in all instances. All isolates were susceptible to penicillin G. Cryptogenic streptococcal abscesses may represent a subset of multiple hepatic abscesses particularly amenable to successful medical therapy consisting of a minimum of 6 weeks parenteral antibiotic therapy followed by a period of oral antibiotics until clinical, biochemical, and radiological resolution of the abscesses has occurred.

Adult↗
PubMed2000

[The immune status and hemorheological indices in patients with an amebic liver abscess].

The immune status and hemorheological indices were studied in 95 patients with amebic abscess of the liver. Changes in the immune status and hemorheological indices were detected according to the clinical course of the disease. In cases of complications appearing during the disease the patients needed immunostimulating therapy and administration of desaggregants. Drainage of the thoracic lymphatic duct is thought by the authors to be a necessary component of treatment while performing massive infusion therapy and adequate recovery of the loss of blood proteins.

Hemorheology↗
PubMed1992

[Endovascular regional infusion therapy in the combined treatment of liver abscess].

The comparative assessment of the effectiveness of endovascular regional infusion therapy (ERIT) in the complex of treatment of a hepatic abscess in 16 patients was carried out. In 12 patients, it was performed in combination with surgical intervention, in 4--as an independent method of treatment. In patients with a solitary hepatic abscess, it is expedient to include ERIT into the complex of therapeutic measures in combination with abscess puncture under ultrasound guidance. In presence of multiple abscesses of the liver, ERIT is a method of choice.

Adolescent↗
PubMedDate not supplied

Unusual presentation of enteric fever: three cases of splenic and liver abscesses due to Salmonella typhi and Salmonella paratyphi A.

Enteric fever is a multisystem disorder caused mainly by Salmonella typhi and Salmonella paratyphi A. It continues to be a major public health problem, especially in developing countries. Unusual presentations of Salmonellosis are rare. We report 3 such cases of young adult males, one of splenic abscess due to Salmonella typhi and one each of liver abscess due to Salmonella typhi and Salmonella paratyphi A. A brief review of the literature pertaining to the cases is also given.

Abscess↗
PubMedDate not supplied

[The prognosis of the course of amebic liver abscess by the indices of the immune status].

The study of T- and B-lymphocyte content in 95 patients with amoeba-induced abscess in the liver has shown that the onset of complications are accompanied by secondary immune failure, which must be corrected with immunomodulators (T-activin, levamizole, gamma-globulin, antistaphylococcal plasma). A group of patients has been identified who despite pyo-resorptive fever are characterized by high resistance and good compensatory reactions. This group needs no special correction of the immune status. The prognostic formula suggested by the authors is based on clinical, laboratory and immunological indexes and promotes to the rational choice of immunocorrective therapy and to patients rehabilitation.

Algorithms↗
PubMed1983

[Diagnostic and therapeutic problems in amebic liver abscess].

Abscesses of the liver represent the most common complications of amebiasis. In general they are treated non-surgically by the aid of Metronidazol. Complications, however, such as perforations, development of fistulas or septicemia may occur and necessitate surgical intervention. The role of CT in diagnostic problems and therapeutic management is discussed in three different cases with respect to other diagnostic techniques.

Adult↗
PubMed1997

[Liver abscess in the course of ulcerative colitis].

The case of 19 year old female patient treated because of the ulcerative colitis. The abscess of the liver has appeared in this patient. This kind of complication has been never described in medical literature.

Adult↗
PubMed2000

Interaction of antibodies with Entamoeba histolytica trophozoites from experimental amebic liver abscess: an immunocytochemical study.

Using immunocytochemical techniques, we studied the interaction of antibodies with Entamoeba histolytica trophozoites present during the development of amebic liver abscess. Hamsters were intrahepatically inoculated with HM1-IMSS axenic amebas and sacrificed at different days post-inoculation. IgG of rabbit anti-E. histolytica and IgG of rabbit anti-IgG of hamster were used, both labeled with peroxidase. With the rabbit anti-E. histolytica, all trophozoites present in hepatic lesions from 1-7 days post-inoculation were highly labeled. The IgG of rabbit anti-IgG of hamster intensively stained only those trophozoites present in lesions from 1-2 days post-inoculation. From day 3, the intensity and number of labeled trophozoites decreased progressively. The results suggest that the interaction between the amebas and the IgG of hamster is non-specific during the first 2 days. The absence of labeling in the chronic stages could be due to changes in the membrane antigens of the parasite or to alterations in the bloodstream around necrosis. Also, the anti-E. histolytica antibodies produced in the serum during the development of the hepatic disease are apparently incapable of reaching and interacting with the trophozoites present on the liver abscess. This can explain in part why antibodies do not have an important role in the defense of the host.

Animals↗
PubMed1998

Septic metastatic endophthalmitis from Klebsiella pneumoniae liver abscess: CT and MR imaging characteristics--report of three cases.

Computed tomography (CT) and magnetic resonance (MR) imaging were performed in three diabetic patients with endophthalmitis and liver abscess secondary to Klebsiella pneumoniae infection. Ocular abnormalities included early uveoscleral thickening, fulminant exudative vitreous humor, and late phthisis bulbi. Characteristic imaging findings of endophthalmitis in diabetic patients with liver abscess should raise a high index of suspicion for K pneumoniae infection.

Abscess↗
PubMed1994

Protection of gerbils from amebic liver abscess by immunization with a recombinant protein derived from the 170-kilodalton surface adhesin of Entamoeba histolytica.

The protozoan parasite Entamoeba histolytica causes extensive morbidity and mortality worldwide through intestinal infection and amebic liver abscess. Here we show that vaccination of gerbils, a standard model for amebic liver abscess, with recombinant proteins derived from the 170-kDa galactose-binding adhesin of E. histolytica and the serine-rich E. histolytica protein or a combination of the two recombinant antigens provides excellent protection against subsequent hepatic challenge with virulent E. histolytica trophozoites.

Animals↗
PubMed1993

Hepatic lymphoma mimicking liver abscess: report of a case and review of the literature.

Early detection of hepatic lymphoma involvement is of prime importance, as it affects the choice of treatment and the prognosis. However, clinical recognition of these lesions at the time of initial staging or during the course of the disease is difficult because infiltration by lymphoma is usually diffuse rather than focal. We describe a 64-year-old man with a previous history of peripheral T-cell lymphoma involving the lung, skin and inguinal lymph nodes. After six months of chemotherapy resulting in a complete clinical remission, he suffered from an intermittent fever and right upper quadrant pain one week prior to admission. Abdominal ultrasonography and computed tomography disclosed a 6.0 x 5.7 cm heterogeneous mass in the liver. The serum alfafetoprotein level was within the normal limits and an indirect hemagglutinin titer for ameba was negative. The patient was initially treated for a liver abscess until a liver biopsy showed malignant lymphoma. Chemotherapy was initiated and the tumor was remarkable reduced in size, with a final dimension of 2.3 x 2.2 cm before discharge. radiologic patterns of hepatic lymphoma and its differential diagnosis are discussed in this report.

Diagnosis, Differential↗