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At least 811 records · Page 45Linked to original sources
PubMed1976

Amoebic liver abscess in Rhodesian Africans.

Eighty-eight African patients with amoebic liver abscess are described. The diagnosis was readily made in pyrexial patients who had right-sided upper abdominal pain, an enlarged, very tender liver and signs at the right base. However, in apyrexial subjects (10%) and where abdominal pain was absent (7%), the diagnosis was considerably delayed. Five children (7%) were seen under the age of five, four of whom died because the diagnosis was not suspected. It is particularly emphasized that there should be a greater awareness of this condition in this age group. Amoebae were found in only a small percentage of stool (14%) and pus specimens (11%), while biopsy of the abscess edge yielded 40%. The relative values of a positive amoebic latex test (82%) and an elevated alkaline phosphatase (71%) are noted. In only half the aspirations was the classical anchovy sauce appearance seen. Metronidazole is the drug of choice with repeated aspirations for large abscesses. Mortality was 13-5%, occurring mainly in the extremes of life.

Adolescent↗
PubMedDate not supplied

Actinomycotic liver abscess. Case report and review of the literature.

Actinomycosis is a chronic suppurative, granulomatous disease, which is characterized clinically by extensive necrosis and abscess formation, and histologically by the presence of the so-called "sulphur granules". Actinomycosis is generally classified as being of cervicofacial, thoracic or abdominal type. The objective of this study is the presentation of a case of actinomycotic liver abscess that we encountered in our department 5 years ago, along with a brief review of this rare disease. A 39-year-old male non-Greek Caucasian patient presented with high fever, malaise, anorexia, vomiting after food ingestion and right upper quadrant pain. Leucocytosis with a left shift was present, and ultrasonography demonstrated a mass of mixed composition in the anterior part of the right hepatic lobe, measuring 6.8 x 4.6 cm, suggestive of an abscess or haemangioma. MRI scan confirmed the presence of a space-occupying lesion, suggestive of an abscess. The patient was submitted to surgical drainage of the hepatic abscess. The culture of the purulent material was found to be sterile, while the histochemical examination of the specimen demonstrated the presence of actinomycosis. The patient had an uneventful postoperative course and after discharge received prolonged chemoprophylaxis. Actinomycotic liver abscess is a very rare clinical entity, and only 57 cases have been reported in the English literature. Due to the rarity of the disease and the limited number of reported cases, we considered it useful to report this case.

Actinomycosis↗
PubMedDate not supplied

Pyogenic liver abscess: multivariate analysis of risk factors.

Seventy-three patients with pyogenic liver abscess during the year 1978-1988 were studied in the Kaohsiung Medical College Hospital. The overall mortality rate was 19.2% in this study. By using univariate analysis, it was revealed that clinical jaundice, pleural effusion, bilobar abscess, profound hypoalbuminemia (less than 2.5 g/dl), hyperbilirubinemia (less than 2 mg/dl), elevated level of serum AST (greater than 100 IU/L), alkaline phosphatase (greater than 150 IU/L), and marked leukocytosis (greater than 20,000 mm3) were associated with a higher mortality rate. Multivariate stepwise logistic regression analysis detected only 3 factors of marked leukocytosis (greater than 20,000 mm3), profound hypoalbuminemia (less than 2.5 g/dl), and presence of pleural effusion with independent significance in predicting mortality. Meanwhile, it was also revealed that the laboratory data could not predict a risk factor to mortality unless they became markedly abnormal.

Adult↗
PubMed2000

Ruptured Klebsiella pneumoniae liver abscess after high-dose cyclophosphamide for severe aplastic anemia.

A 19-year-old woman with severe aplastic anemia who had previously failed antithymocyte globulin/cyclosporine A received high-dose cyclophosphamide without bone marrow rescue. On day +14, she complained of right upper quadrant abdominal pain and fever. A CT scan of the abdomen showed multiple liver abscesses with rupture and Klebsiella pneumoniae was isolated from blood. In spite of aggressive antibiotic therapy, she rapidly deteriorated and died of overwhelming sepsis. To our knowledge, our patient is the first case of fatal ruptured liver abscess after high-dose cyclophosphamide in a patient with severe aplastic anemia.

Adult↗
PubMedDate not supplied

Amebic liver abscess "a 5 year Mexican experience with a multimodality approach".

BACKGROUND/AIMS: Amebic liver abscess is a frequent problem in Mexico. The morbidity and mortality is reported to be high in different series. The aim of this study was to evaluate the morbidity and mortality of ALA in our center and evaluate our current management used. MATERIALS AND METHODS: Fifty patients were included in our study. Thirty-four (68%) were males, 16 (22%) were females. The age range was between 22 and 83 years (mean 50 years). The majority presented abdominal pain (95%), fever (82%) and hepatomegaly (72%). leukocytosis was observed in 72%, hypoalbuminaemia in 62%, thrombocytosis in 42%. The seroemeba reaction was positive in 90%. The diagnostic methods used were ultrasound in 42, computed tomography in 20 and isotope scan in 12. RESULTS: Medical treatment alone was used in 24 patients, 15 required percutaneous drainage and 11 surgery. Fifteen patients (38%) presented medical complications. The hospital stay raged between 5 and 44 days (mean 15 days). One patient died in a median follow up of 31.4 months. Multimodality management was liberally used in our patients. Amebicidal drugs were used initially and controlled the disease in 24 patients, 15 patients required percutaneous drainage because of lack of control of the disease or risk of complications and 11 patients required surgery to treat complications. CONCLUSION: With these approaches the morbidity and mortality of ALA in our center has remained low.

Adult↗
PubMed1975

Amebic pericardial effusion: a rare complication of amebic liver abscess.

Two rare cases of amebic pericardial effusion as a complication of amoebic liver abscess in the left lobe are described. The pericardial amebiasis should be suspected in a patient presenting with signs and symptoms of pericardial effusion with an evidence of hepatic abscess (in the left lobe) or in a patient with pericardial effusion of uncertain etiology. Aspiration of "anchovy sauce" pus from both the pericardial cavity and the liver should be regarded as confirming the diagnosis of amebic pericarditis secondary to amebic liver abcess because demonstration of Entamoeba hystolytica is seldom possible. Removal of pericardial pus and metronidazole intake were markedly effective in treating our patients.

Adult↗
PubMed1978

Amoebic liver abscess and clinical experiences with tinidazole in Bangladesh.

35 cases of amoebic liver abscess have been studied and their clinical diagnostic features analyzed. The diagnosis was based on WHO criteria of enlarged tender liver, leucocytosis and aspiration of typical anchovy sauce pus from the abscess. The authors have however, suggested major and minor diagnostic criteria for the condition. These cases were all treated with new nitroimidazole derivative Tinidazole in a single dose of 2 gm daily for consecutive 2 or 3 days. All the cases were followed up for at least 2 months. 100 per cent cure rate was observed. However, in 7 cases the dosage had to be repeated. Minor side effects were noted. The liver function tests and blood chemistry done pretreatment and post-treatment did not show any drug related toxicity.

Adolescent↗
PubMed1991

[Liver abscesses due to Yersinia enterocolitica].

A 41-year-old man with type II diabetes for the past five years had for three weeks been suffering from high fever (up to 40 degrees), feeling of pressure in the upper abdomen, loss of weight, lack of appetite and increasing weakness. Ultrasound examination as an out-patient was suspicious of diffuse liver metastases from an unknown primary tumour. Ultrasonography and computed tomography after hospitalization suggested multiple liver abscesses. Fine-needle biopsy grew Yersinia enterocolitica. In addition, there was evidence of an asymptomatic intestinal Yersinia infection without septicaemia. After intravenous treatment with three times daily 5 g mezlocillin and three times daily 80 mg tobramycin the fever at first subsided, but the liver abscesses remained unchanged. When fever recurred a week later, cefotaxim, three times daily 2 g, was started. This led to complete regression of the abscesses within three weeks, and the patient has been free of symptoms since.

Adult↗
PubMed1995

Importance of E. histolytica antigen in serodiagnosis and follow up of patients with amoebic liver abscess.

This study is composed of a community based study and a hospital based study. The community based study was conducted on 200 apparently healthy individuals randomly chosen from rural areas. They were examined clinically, sonographically and parasitologically for E. histolytica cysts and by ELISA for circulating amoebic antigen. They were negative for antigenaemia at 1/16 which was considered the diagnostic titre of amoebic hepatitis. The hospital based study was carried out on 27 patients suffering from amoebic liver abscess (ALA). Circulating amoebic antigen was detected in 66.66% of them before treatment which decreased to 14.82% two months after treatment. There was no significant association between the diameter of the abscess and the level of circulating amoebic antigen. It was concluded that the circulating amoebic antigen may be useful for the diagnosis and follow up of amoebic liver abscess patients.

Adolescent↗
PubMed2004

Immunosuppressive treatment inhibits the development of amebic liver abscesses in hamsters.

BACKGROUND: The aim of the present study was to determine if the inflammation and/or immunosuppression induced by Entamoeba histolytica may contribute to amebic invasion. MATERIAL/METHODS: Dexamethasone was administered three days before and three days after inoculation of hamsters with E. histolytica. Seven days alter inoculation the animals were sacrificed and the sizes of their amebic liver abscesses were determined. The number of neutrophils, macrophages, T and B cells in the peritoneum as well as the production of nitric oxide and the susceptibility to Listeria monocytogenes infection was also determined. RESULTS: Dexamethasone treatment significantly reduced the number of T lymphocytes in thymus and spleen. The number of neutrophils, macrophages and T lymphocytes in the peritoneal exudate was also reduced as well as the production of nitric oxide and the microbicidal activity against Listeria monocytogenes. However, in the animals treated with a high dose of dexamethasone the size of the liver abscesses was significantly smaller than in the untreated animals. CONCLUSIONS: The results suggest that macrophage and T cell-mediated immunity is not relevant as a protective mechanism because tissue invasion by E. histolytica was reduced in immunosuppresed animals. On the contrary, the inflammatory process may contribute to the invasion and liver damage.

Animals↗
PubMed2003

Effective human defense against E. histolytica: high amoebicidal activity of lymphocytes and monocytes in amoebic liver abscess patients until 3 months follow-up.

Adherence of pathogenic Entamoeba histolytica trophozoites mediated by Gal/GalNAc lectin is a prerequisite for killing naïve T cells and monocytes but the activated T cells and monocyte derived macrophages (MDMs) not only resist the attack but can kill the parasite. In the present study, we have analysed the adherence and cytotoxicity of the immunecompetent cells from patients of amoebic liver abscess at the time of their diagnosis and after 3 months to elucidate the development of cell mediated cytotoxicity, a major mechanism of resistance to amoebic infection. The results show that CD3+ cells from amoebic liver abscess cases, when stimulated, in vitro, bound E. histolytica trophozoites with increased intensity and their viability was also increased. The activated lymphocytes (taken at 3 months post treatment) were also able to kill amoebae. MDMs bound amoebae with greater intensity than lymphocytes, until 3 months post infection. These MDMs were effective in killing approximately 40% amoebae which was significantly less than at the time of diagnosis but was very significant as compared to the controls. The data suggest that cell mediated cytotoxic responses are maximum until 1 month post treatment and are significantly reduced thereafter.

Adult↗
PubMed1994

Leucocyte migration inhibition index responses of patients of amoebic liver abscess to various antigens of Entamoeba histolytica.

The whole amoebic lysate (WAL), Sephadex G-200 eluted fraction-I. (F-I), detergent dissected membrane proteins (DDMP), amoebic membrane glycoprotein (AMG) and amoebal RNA were extracted from E. histolytica. Amoebal RNA recognized 98.21% where as F-I, AMG, DDMP and WAL recognised 92.85, 91.07, 89.28 and 75% of total 56 clinically proven and amoebic serology positive amoebic liver abscess cases respectively. Intensity of recognition of individual fraction i.e., leucocyte migration inhibition index of each fraction was found to be highly significant (P < 0.001) when compared to whole amoebic lysate. This indicate the leucocyte migration inhibition index responses of patients of amoebic liver abscess to various antigenic fractions of E. histolytica with variations.

Adult↗
PubMedDate not supplied

Pyogenic liver abscess. Diagnostic and therapeutic approach: a case report.

We report a case of liver abscess secondary to an asymptomatic, subacute appendicitis in a 51-year-old man. The general condition of the patient was altered but there were no gastrointestinal signs. Treatment consisted in broad-spectrum antibiotics, followed by surgical drainage of the abscess and appendicectomy.

Anti-Bacterial Agents↗
PubMed1983

Enterococcal liver abscess associated with moxalactam therapy. Review of literature on enterococcal superinfections in association with moxalactam therapy.

Moxalactam, a third-generation cephalosporin, has been demonstrated to have an ultrawide spectrum of antibacterial activity. One important gap in this impressive spectrum is the enterococcus. Superinfections and colonization with enterococci have been reported following moxalactam therapy. Sites involved have included the urinary tract, wounds, middle ear, and blood stream. To our knowledge, we report the first case of enterococcal liver abscess following moxalactam therapy. The abscess was localized by ultrasound examination and microbiologic diagnosis made by aspiration using a skinny needle. Without surgical drainage or therapeutic aspiration, institution of appropriate antibiotic therapy in optimum dosage resulted in complete resolution. The literature on enterococcal superinfections in association with moxalactam therapy and nonsurgical management of liver abscesses is reviewed.

Cephalosporins↗