[AMEBIC LIVER ABSCESS OPENING INTO THE PERICARDIUM].
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Cardiac Tamponade↗
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LIVER ABSCESS CAUSED BY ADULT ASCARIS LUMBRICOIDES.
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Animals↗
[Liver abscess caused by hepatic artery infusion chemotherapy].
A 48-year-old man underwent left hemicolectomy and right extended hepatectomy for colon cancer and its synchronous multiple liver metastasis. Sixteen months after, multiple metastases in the remnant liver were found, so he was given bolus hepatic infusion of 5-FU 1,000 mg/week, total amount, 25 g. The response was CR, but he developed a liver abscess in segment 4.
Adenocarcinoma↗
Amebic liver abscess.
50 patients, with ages ranging from eight to 55 years, suffering from amebic liver abscess (ALA), have been studied. 90% of these patients were males. The abscess was located in the left lobe of the liver in nine cases and involved both lobes in four cases. In 17 patients, the abscess had already ruptured at the time of admission and, in four cases, it was about to rupture. In seven patients the diagnosis of ALA could only be made on laparotomy. The treatment is primarily conservative; antiamebic drugs, antiobiotic supportive therapy and aspiration of the abscess. Twenty-seven patients required surgery in the form of laparotomy and drainage of empyema. The preoperative use of antiamebic drugs directly influenced the results of surgery. Five patients died. None of them had any antiamebic treatment preoperatively and in 80% of these the diagnosis was only made after laparotomy.
Adolescent↗
Liver abscess at the Hadassah University during years 1967-77.
The charts of 36 patients, 27 males and 9 females, with liver abscess diagnosed at the Hadassah University Hospital between 1967-1977 were reviewed. The patients ranged in age from two months to 80 years and 25 patients (69%) were older than 40 years. The diagnosis was initially suggested by liver scan in 18 patients (50%), and was first made at autopsy in six (17%). The time-lapse between the onset of illness and diagnosis ranged from one day to 13 months, with a bimodal distribution. Large solitary abscesses were diagnosed later than small multiple abscesses. Ten patients (28%) were admitted with fever as the only sign of illness; specific signs and laboratory evidence of liver involvement often occurred late in the course of the disease. In 15 patients (42%), the etiology was regarded as amebic. In patients with pyogenic abscesses, the most commonly isolated organisms belonged to the normal bowel flora and biliary tract disease was present in 62% (13/21) of these patients. The overall mortality rate was 31%. This survey stresses the need for an increased awareness of the subtle presentation of liver abscess.
Adolescent↗
Amoebic liver abscess: clinical presentation and diagnosis.
The clinical profiles of 16 patients with amoebic liver abscesses referred to Royal Perth Hospital over a ten-year period were assessed. The results indicate that amoebic abscess should be suspected in Asian migrants and farmers, or patients who have travelled in endemic areas, who present with fever, anorexia, weight loss and abdominal pain. Localized right hypochondriac tenderness, hepatomegaly and chest signs may be exhibited. The presence of anaemia, leucocytosis and marked elevation of the ESR, with moderate elevation of the serum alkaline phosphatase level, should heighten the probability of the diagnosis, which is readily confirmed by radionuclide liver scan or ultrasound, and elevation of the Entamoeba histolytica fluorescent antibody titre. The availability of metronidazole as a potent amoebicidal drug has reduced the need for surgical intervention in this condition.
Abdomen↗
Amebic liver abscesses masquerading as pyemic abscesses.
We describe a 50-year-old man who presented with multiple liver abscesses that suggested biliary sepsis or portal pyemia. A wet preparation of a sample of aspirate showed the presence of amebic trophozoites, and subsequent serological testing for amebae was strongly reactive.
Bile Duct Diseases↗
[The spontaneous rupture of a pyogenic liver abscess. A clinical case].
The authors report a case of a large monolocular liver abscess in a patient with gallbladder and choledocic stones and biliary stent, complicated by rupture into the peritoneal cavity, that required surgical treatment. Surgical exploration versus other approach results the choice treatment, as shown by resolution of the pathology.
Aged↗
Gastric wall erosion by an amebic liver abscess in a 3-year-old girl.
The occurrence of an amebic liver abscess (ALA) rupturing into the stomach is reported. ALAs in children can have atypical presentations, resulting in delayed diagnosis and increased morbidity and mortality. Timely treatment is usually followed by complete recovery.
Amebicides↗
Amebic liver abscess: 1966-1976.
A 10-year retrospective analysis of 15 patients with amebic liver abscess is reviewed and represents a continuation of the previous 2-decade experience at our institution (37 patients). Records were studied to determine the population affected, presenting symptoms, physical and laboratory findings, type and response to therapy. Most patients were rural males of lower socioeconomic status in the third to fifth decade of life. They presened as a febrile illness with abdominal pain for an average of 2 1/2 months duration. Significanct physical abnormalities were tender hepatomegaly (93%), right-sided pulmonary changes (40%), and fever (66%). All patients had abnormal liver scan, positive amebic serology, and hypoalbuminemia. All patients promptly responded to amebicidal therapy except one whose therapy was delayed. Clinical suspicion, liver scanning, serologic testing, and response to therapy are the keys to diagnosis.
Adult↗
[A case of ventriculitis with bacterial meningitis occurred during the treatment of liver abscess].
A 47-case-year old male was admitted to our hospital because of high fever and general fatigue. He had no immune deficiency, and had no other disease in his past history. On admission, the white blood cell count and C-reacted protein were severely elevated (18,700/microliter, 27.7 mg/dl, respectively) and abdominal CT revealed multiple low density, From these results, he was diagnosed as liver abscess. Intravenous MINO and SBT/CPZ injection were started. On the fifth hospital day, he suffered from headache and nuchal rigidity. The clinical data revealed the cerebro-spinal fluid (CSF) counting 8,336 cells/mm3 (mononuclear 8,000,) protein at 119 mg/dl, and sugar 42 mg/dl. CSF cultures were negative, but Klebsiella was recognized in the blood culture and drainage fluid in liver abscess. This condition was diagnosed as bacterial meningitis and antibiotics were changed to intravenous CTRX and MEPM. Furthermore we administered oral PSL and intravenous steroid-pulse therapy. After these combination therapies his condition improved gradually. After 40 hospital day, however, he suddenly had double vision, Axial FLAIR (SE6,000/120) image revealed with high signal intensity at 4th ventricle. Intravenous MEPM was administered again. On the 60th hospital day, double vision was gradually improved and abnormal intensity at 4th ventricle was almost disappeared. This case may provide us a considerable suggestion on the treatment of bacterial meningitis.
Cerebral Ventricles↗
Oral vaccination with recombinant Yersinia enterocolitica expressing hybrid type III proteins protects gerbils from amebic liver abscess.
Protection against invasive amebiasis was achieved in the gerbil model for amebic liver abscess by oral immunization with live attenuated Yersinia enterocolitica expressing the Entamoeba histolytica galactose-inhibitable lectin that has been fused to the Yersinia outer protein E (YopE). Protection was dependent on the presence of the YopE translocation domain but was independent from the antibody response to the ameba lectin.
Administration, Oral↗
Pyogenic liver abscess due to Rhodococcus equi in an immunocompetent host.
A case of pyogenic liver abscess (PLA) due to Rhodococcus equi in an immunocompetent individual was successfully treated by combining surgery and antibiotics. The R. equi-targeted antimicrobial agents erythromycin and rifampin were used only after surgical resection of the lesion and identification of the infective organism.
Actinomycetales Infections↗
Metronidazole treatment of liver abscess due to bacteroides fragilis.
A 67-year-old woman with a liver abscess due to Bacteroides fragilis was treated with metronidazole 0.4 g orally every 8 h for 6 weeks. There was a rapid clinical improvement even though no surgical drainage was performed. By the indirect immunofluorescence technique using the patient's own strain as an antigen the antibody titer declined from 5120 to 80 in 6 months, suggesting eradication of the infecting agent.
Administration, Oral↗
Clinical presentation of pyogenic liver abscess in the elderly.
The presenting features of seven elderly patients with pyogenic liver abscess were reviewed retrospectively. Symptoms of malaise, anorexia and abdominal pain referrable to intra-abdominal pathology were present in only 43% cases and physical examination was frequently unhelpful. Leucocytosis, hyperbilirubinaemia and raised alkaline phosphatase were of diagnostic value in the majority of patients. Chest and urinary tract infections were frequent predisposing conditions. Antibiotic therapy for four weeks is adequate in elderly patients if combined with drainage procedures.
Abdomen↗
Hemoptysis demonstrated on Tc99m-sulfur colloid scanning: a rare complication of amoebic liver abscess.
We report the finding of bleeding into right lung from a ruptured amoebic liver abscess. A 25-year-old male presented with pain in the right lower chest and cough associated with expectoration of chocolate-colored sputum. Radiographs of chest showed right-sided pleural effusion. Serial images of Tc99m-sulfur colloid study revealed progressive accumulation of radiotracer in the upper photopenic area extending into the right lung region suggestive of active bleeding from the abscess cavity.
Adult↗
Entamoeba histolytica: elevated nitroblue tetrazolium reduction activity in polymorphs during amoebic liver abscess.
Peripheral blood polymorphonuclear leucocytes (PMN) from patients with invasive amoebiasis, i.e. amoebic liver abscess (ALA) and acute amoebic dysentery, showed marked elevation of nitroblue tetrazolium dye (NBT) reduction. This dramatic change was not observed in PMN from patients with non-invasive amoebiasis, i.e. non-suppurative hepatic amoebiasis, or in asymptomatic Entamoeba histolytica cyst passers. A small number (12%) of patients with viral hepatitis displayed increased NBT reduction. 10 to 12 days after recovery following treatment, the majority (75%) of ALA patients failed to show increased NBT reduction. Our results suggest that the PMN-NBT reduction test could be useful as an aid to the diagnosis of ALA.
Dysentery, Amebic↗
Pyogenic liver abscess: a retrospective analysis of 107 patients during a 3-year period.
Pyogenic liver abscess (PLA) is a potentially life-threatening disease, and early diagnosis may be difficult. In order to provide diagnostic clues and to enhance the prompt management of such cases, we retrospectively investigated the clinical characteristics of PLA during a 3-year period in a tertiary-care hospital. The crude incidence rate of PLA in our study was 446.1 per 100,000 hospital admissions. Male predominance and a mean age of 57.6 +/- 14.4 years were observed. Diabetes mellitus was the most common concomitant disease, and biliary pathologies were the most common predisposing cause of this type of abscess. The most common clinical features were fever, chills, and abdominal pain. Leukocytosis was found in 67.3% of the patients, and the observed C-reactive protein (CRP) values were high. The most common pathogen was Klebsiella pneumoniae. The mortality rate was 6.5%. A complete history, physical examination, evaluation of the white blood cell count and CRP, and the prompt arrangement of imaging studies may lead to an earlier diagnosis. The aggressive performance of image-guided catheter drainage and the appropriate administration of antibiotics may reduce the mortality rate of PLA.
Adult↗