Treatment of Patients with Pyogenic Liver Abscess

• Published in: Chemotherapy (Basel) Vol. 51; no. 6; pp. 366 - 369
• Main Authors: Cerwenka, H., Bacher, H., Werkgartner, G., El-Shabrawi, A., Kornprat, P., Bernhardt, G.A., Mischinger, H.J.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.10.2005; S. Karger AG
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biliary Fistula - complications; Biliary Fistula - pathology; Biological and medical sciences; Cell Culture Techniques; Chemotherapy; Clinical Study; Diagnostic tests; Drainage; Female; Humans; Liver; Liver Abscess, Pyogenic - diagnosis; Liver Abscess, Pyogenic - etiology; Liver Abscess, Pyogenic - surgery; Liver Abscess, Pyogenic - therapy; Male; Medical disorders; Medical sciences; Medical treatment; Microbial Sensitivity Tests; Pharmacology. Drug treatments; Retrospective Studies; Tomography, X-Ray Computed; Biliary fistula; Microbiological culture; Chemotherapy; Surgical drainage; Antibiotic therapy; Percutaneous drainage; Pyogenic liver abscess; Antibiotic sensitivity testing; Posttraumatic liver abscess; Human; Biliary tract; Hepatic disease; Fistula; Medical screening; Percutaneous route; Pyogenic; Antibiotic; Sensitivity; Treatment; Digestive diseases; Liver abscess; Antibacterial agent
• ISSN: 0009-3157; 1421-9794
• DOI: 10.1159/000088964

Background: Pyogenic liver abscess (PLA) remains a serious disease with a mortality of 6–14%. Methods: Clinical data of 76 patients with PLA were analyzed. Treatment options comprised antibiotics, percutaneous puncture/drainage, endoscopic papillotomy/stenting and/or surgery as indicated. Results: Fifty-eight patients (76%) had single and 18 patients multiple PLA (right lobe: 65%; both lobes: 22%). The most frequent etiologies were: biliary (38%), hematogenous and posttraumatic (11%). Factors associated with the need for surgery included gallbladder empyema, biliary fistulas, malignancy, perforation, multicentricity, vascular complications and foreign bodies (e.g. infected ventriculo-peritoneal shunt, toothpick). Conclusions: Microbiological testing provides important information for treatment monitoring and modification. Complementary assessment of risk factors for a complicated course is crucial for timely identification of patients requiring additional treatment.