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PubMedDate not supplied

Hypoplastic right hepatic lobe with retrohepatic gallbladder complicated by hepatolithiasis and liver abscess: a case report.

A 37-year-old man with fever, jaundice, severe right upper quadrant abdominal pain and impending septic shock was pre-operatively diagnosed to have hypoplastic right lobe liver with retrohepatic gallbladder, left hepatolithiasis and liver abscess by computed tomography. An urgent operation with cholecystectomy, choledocholithotomy, operative choledochoscopy and T-tube drainage was performed. Postoperative cholangiograms depicted multiple residual stones behind the sharply angulated biliary strictures in the medial branches of the left intrahepatic duct, which could not be eradicated by biliary dilatation via the T-tube tract. The left hepatolithiasis might be coincidental, or secondary to the congenital anomaly of the liver, because of the distorted biliary architecture, and the hypoplastic right lobe liver was associated not only with the retrohepatic gallbladder, but also with the much more complicated left biliary strictures and the hepatolithiasis behind them.

Adult↗
PubMed1980

Intravenous metronidazole in the treatment of ruptured amebic liver abscess.

Intravenous metronidazole was administered to a patient with peritonitis caused by a ruptured amebic liver abscess. The medication was well tolerated and the patient had a remarkable recovery. The intravenous administration of metronidazole was safe and efficacious therapy for this often fatal disease process.

Adult↗
PubMed1988

Clinical aspects of pyogenic liver abscess: the University Hospital of the West Indies experience.

Twenty-four cases of pyogenic liver abscess admitted between 1977 and 1986 are presented. A mean age of 43 years (range 5-78) with a 3:1 male:female ratio and 25% mortality were noted. Fever and abdominal pain were encountered in over 80% of cases and anorexia and malaise in over 60%. Hepatomegaly and right upper quadrant tenderness were the commonest signs. Leucocytosis, raised alkaline phosphatase and gamma-glutamyl transpeptidase, and hypoalbuminaemia were each noted in roughly 80% of cases. None of these showed any prognostic significance. Predisposing factors were noted in 11 cases. No cases of associated biliary disease were noted. Multiple, polymicrobial, aerobic and mixed aerobic/anaerobic abscesses were associated with a higher mortality. Patients aged over 50 years or more also had a higher mortality (P less than 0.05). Anaerobic abscesses were often solitary and were associated with a lower mortality (P less than 0.05). Surgical drainage and guided percutaneous drainage showed no difference in morbidity.

Adolescent↗
PubMed1980

[Liver abscess in chronic granulomatosis of childhood (author's transl)].

A thirteen-year-old boy with an abscess of the liver and recurrent infections since infancy is described. Aspergillus fumigatus could be isolated from this surgical treated abscess. Polymorphonuclear leukocytes (PMN) and monocytes from the patient show a normal phagocytosis, whereas the oxygen metabolism and the intracellular killing of kastalase-positive microorganismus (Staphylococcus aureus, Candida albicans) are strikingly decreased. In contrast, the catalase-negative Pneumococcus pneumoniae is rapidly killed. The iodination (131 J) of PMN is despite phagocytosis also markedly reduced. Myeloperoxidase could be detected in the phagocytes histochemically. No morphologic abnormalities of PMN have been found by electron microscopy. A defect of the humoral of cellular immunity has been excluded. The characterized dysfunction of PMN and monocytes as well as the clinical features of the patient are consistent with a diagnosis of chronic granulomatous disease of childhood.

Adolescent↗
PubMed2001

Liver abscess caused by Clostridium difficile.

We report the first case of an infected cyst and liver abscess caused by Clostridium difficile. It recurred 11 months later, despite therapy with vancomycin and percutaneous drainage. Administration of metronidazole following percutaneous drainage achieved a favorable outcome.

Aged↗
PubMed2005

[Liver abscesses with portal and mesenteric vein thrombosis in combination with late onset of appendicitis].

Pyogenic liver abscesses are caused by appendicitis in less than 10%. Also the ascending septic inflammation of portal vein (pylephlebitis) could be a serious complication of intra-abdominal infection. Although pylephlebitis is not frequent today, its' mortality and morbidity rates remain high. We describe a case of young man with fever, abdominal pain, and multiple hepatic abscesses. After the symptomatic relief due to antibiotic therapy the pain returned as a result of the development of portal and mesenteric vein thrombosis. The cause of either hepatic abscesses or thrombosis was not clear at the time of dismissal. 2 months later the patient underwent acute abdominal revision with appendectomy for acute phlegmonous and gangrenous appendicitis. Since that time he has been without any clinical symptoms.

Abdomen, Acute↗
PubMed1984

Pyogenic liver abscess complicating common bile duct stenosis secondary to chronic calcific pancreatitis. A rare presentation.

Pyogenic liver abscess is a rare presentation of common bile duct stenosis secondary to chronic calcific pancreatitis. Two cases are described in this report; in both cases, biliary obstruction was present in the absence of jaundice. Successful therapy of the abscesses was accomplished with antibiotics alone and without continuous percutaneous drainage or surgical intervention. Definitive therapy should include eventual surgical correction of the biliary obstruction.

Adult↗
PubMedDate not supplied

[Liver abscess in childhood: report of 8 cases].

The authors present eight cases of children with liver abscess diagnosed in the Pediatric Nursery of the "Hospital das Clínicas", State University of Campinas, SP, Brazil, during eight years. Five children were younger than five years. They were four boys and four girls. The symptomatology was inespecific. Staphylococcus aureus was the more frequent etiologic agent and in two cases it was seen Ascaris lumbricoides worm inside the abscess. The findings of ultrasound and computadorized tomography were similar. In most cases, were employed the association of broad spectrum antibiotics and percutaneous draining, and a good clinical outcome was observed in all patients.

Anti-Bacterial Agents↗
PubMed1978

The results of surgery in amebic liver abscess: experiences in eighty-three patients.

Experiences with surgery in 83 patients with amebic liver abscess are presented. The patients' ages ranged from 8 months to 72 years; 85% were men. Symptoms had been present for an average of 4.6 weeks. In 36 (43%) the abscess already was ruptured at the time of admission to the hospital and in an additional eight it ruptured later. Rupture occurred more commonly upward through the diaphragm than downward, and into a serous cavity in 36 patients. Because of the poor general condition and associated illnesses of the patients, surgical procedures were limited to the minimum. Indications for operation were rupture or impending rupture of the abscess, failure of response to medical therapy, and inadequacy of aspiration of left lobe abscess. An additional 27 patients underwent operation because of diagnostic problems or symptoms of an acute abdomen. Two thirds of the patients had one or more complication. The overall mortality rate was 34%. Factors adversely affecting mortality rate were lack of preoperative drug therapy, rupture into a serous cavity, and presence of an associated amebic perforation of the colon.

Adolescent↗
PubMed1977

Tinidazole and metronidazole in the treatment of amoebic liver abscess.

Tinidazole, a new drug effective against E histolytica, was studied in patients with amoebic liver abscess proved by aspiration of pus. A preliminary open evaluation in fourteen patients provided a cure in all cases. A subsequent comparative study against metronidazole in another twenty-two patients led to a cure in all eleven patients treated with tinidazole and in ten out of eleven patients treated with metronidazole. The response was faster in patients treated with tinidazole. Tinidazole was totally free from side-effects. Tinidazole is a noteworthy addition to anti-amoebic therapy.

Adult↗
PubMed1990

Immunoreactivities for Entamoeba histolytica in patients with amebic liver abscesses.

We defined the major specificities of antibodies present in sera from patients with amebic liver abscesses, diagnosed by gamagrafia. These immune reactivities were analyzed against plasma membrane and extract antigens of Entamoeba histolytica, resolved by electrophoresis and blotted to nitrocellulose scheets. We observed that each of the 26 patients revealed a distinct pattern in the plasma membrane and in the total extract preparations. Most of these sera detected a prominent plasma membrane polypeptide of 166 kDa. We also observed that the same pattern of specificities persisted in the patients sera for six months after treatment.

Animals↗
PubMed1984

Intrathoracic complications of amoebic liver abscess.

Amoebiasis is a world-wide parasitic infestation but is more prevalent and virulent in warm countries. Of 33 patients with amoebic liver abscess (ALA) seen over a 5-year period, 24 had intrathoracic complications. Management consisted mainly of the administration of the antiamoebic agent metronidazole (Flagyl), repeated needle aspiration of ALA and surgical drainage when aspiration failed. Closed tube thoracostomy was the preferred management of amoebic empyema. Associated cerebral involvement in 4 cases improved with parenteral metronidazole. Pericardial amoebic abscess claimed 100% mortality in our series.

Adolescent↗
PubMed1982

Pyogenic liver abscess: a study of forty-four cases in two centres.

44 patients with pyogenic liver abscess, 22 each from Leicester, UK, and Göteborg, Sweden, presenting between 1972 and 1980 have been reviewed. 29 patients were diagnosed prior to specific treatment with 3 deaths (10%); 15 patients were first discovered at autopsy resulting in an overall mortality of 41%. The presentation, pathogenesis, and treatment are discussed in detail. It is concluded that the continuing high mortality of this condition largely relates to the difficulty in establishing the diagnosis. Reduced morbidity (and perhaps mortality) might be achieved with wider use of percutaneous methods of drainage.

Adolescent↗
PubMed1990

Serum immunoglobulins and complement in patients suffering from amoebic liver abscess.

Immunoglobulins IgG, IgM & IgA and complement C3 were studied in 24 patients suffering from amoebic liver abscesses (ALA) before and two months after therapy. The results were compared with those of 12 healthy controls. IgG and IgA showed significant higher level in ALA patients than the normal controls, P less than 0.001 and P less than 0.01 respectively. IgM level was also higher than the normal controls but the difference was insignificant. Follow up of these Igs showed marked drop two months after therapy. C3 level was found statistically higher in ALA before therapy than that of the normal controls and that of patients two months after therapy. Correlation between C3 level and the size of the abscess showed that its level was statistically higher in large abscesses P less than 0.05.

Adolescent↗
PubMedDate not supplied

Pyogenic liver abscess: studies of therapy and analysis of risk factors.

Experience with 46 patients diagnosed with liver abscesses over a 13-year period was reviewed to ascertain the impact of percutaneous versus surgical drainage. In most of the cases the abscesses were diagnosed by sonography or computed tomography. The most common pathogenetic mechanism was ascending biliary tract infection. Of the 46 total patients, 27 were primarily treated surgically, whereas 19 underwent percutaneous drainage. In the surgical group five (18.5%) patients required reoperation. Percutaneous drainage failed in four patients (21.1%). Multivariate stepwise logistic regression analysis revealed that a high APACHE II score, low hemoglobin level, and high serum bilirubin level were significant predictors of a complicated clinical course. Death was related more closely to the overall condition of the patient, as expressed by a high APACHE II score, and the underlying disease (malignancy) than to the mode of therapy.

Adult↗
PubMed1996

[Amebic liver abscess--personal observations].

In the period of 1989-1995 seven patients with amebic liver abscess were observed in Clinic of Infectious Diseases of Pomeranian Medical School in Szczecin. The diagnosis has been made on the base of epidemiological data, presence of intrahepatic defect by a scanning procedure of liver (ultrasonography, CT, scintigraphy) and positive serologic test for amebiasis. All patients were male of Polish nationality, 29-57 years old, who became ill after travel to Africa or India. Intestinal amebiasis was present only in two cases. Five patients had acute onset of disease and two chronic. The most common complaints included fever, abdominal pain, anorexia. A cough, chest pain, diarrhea or weight lose were less common. At physical examination paleness of skin, subjaundice, abdominal tenderness, hepatomegaly and sometimes pleural effusion have been observed. Laboratory tests revealed high RBS, leucocytosis and mild anemia. Slightly higher serum level of bilirubin, alkaline phosphatase were transient. Trophozoits of Entamoeba histolytica have been found in stool specimens of one only patient. Amebic antibodies tested with indirect hemagglutination (IHA) were present in all cases. Visual technics have shown abscess of 3 to 9 cm in diameter located at right liver lobe. Six patients have been treated with both chemotherapy (metronidazole or/and dehydroemetine) and "skin needle" aspiration. In two cases recrudescence of abscess has been observed after one and three years respectively. These two patients have been undergone second course of treatment with using not only needle aspiration and metronidazole/dehydroemetine but luminal agents as well.

Adult↗
PubMed1989

[Klebsiella pneumoniae meningitis associated with liver abscess: a case report].

We report a rare case of Klebsiella pneumoniae meningitis associated with liver abscess, which was successfully treated with cefotaxime (CTX), one of the third-generation cephalosporins. A 53-year-old man was admitted to Keio University Hospital on June 13, 1988, because of a fever and a headache. On June 3, he suddenly started shivering and his temperature rose to 39 degrees C. He then began to complain of polydipsia, polyuria, and a weight loss of 4 kg a week. On June 11, he developed a severe headache. Four years prior to this incident, he had been diagnosed as having diabetes after a routine medical examination, but had neglected to undergo medical treatment. On admission, laboratory data showed leukocytosis, hyperglycemia (394 mg/dl) and ketonuria (4+). A lumbar puncture yielded cloudy cerebrospinal fluid (CSF) containing 500/3 cells/mm8, of which about 70% were neutrophils. A diagnosis of diabetic ketoacidosis and purulent meningitis was made. A treatment with ampicillin (ABPC) and CTX, (12 g/day, each) was begun. On the third day, cultures of a blood specimen and CSF yielded both K. pneumoniae. The MICs of CTX to K. pneumoniae isolated from blood and CSF were both 0.05 microgram/ml. ABPC was discontinued, gentamicin was administered for 2 days, CTX was continued at the same dosage level and an administration of prednisolone 40 mg daily was begun.(ABSTRACT TRUNCATED AT 250 WORDS)

Cefotaxime↗