Publication
Liver abscess in an Internal Medicine Department: a retrospective study
| Summary: | Background: Liver abscess (LA) is an uncommon pathology thus a rare cause of hospital admission. Although with a lower mortality, at present, it is still important. Prognosis depends on early diagnosis and correct treatment.Objectives: Evaluate all patients with LA admitted in an Internal Medicine Department for a period of ten years. Methods: retrospective, event driven, clinical database analysis. Risk factors, clinical presentation, laboratory findings, imaging studies were verified as well as microbiology tests, pathogen identification, treatment and clinical evolution.Results: a total of 16 patients with LA were admitted. The most frequent risk factors were biliary and abdominal surgery, alcohol habits and diabetes. Clinical presentation was more frequently acute and common manifestations were fever, chills and right upper quadrant abdominal pain. Most frequent laboratory abnormalities included leukocytosis with neutrophilia, increase on the erythrocyte sedimentation rate and serum C–reactive protein, decrease on albumin and increase on aminotransferases, alkaline phosphatase and gamma glutamyl-transpeptidase. Ultrasound and computed tomography were performed in the majority of patients. Blood cultures, performed in all patients, were positive in five. Serological tests were positive in 3 patients. Needle aspiration was performed in half of the patients, with inconclusive results. Eight patients went through percutaneous catheter drainage. Antibiotics were administered for a mean duration of 33.8 days. There was a good clinical response in 15 patients and one case of recurrence.Conclusions: the profile of our patients with LA was similar to those referred in the literature, however the pathogen identification was only achieved in half of them. There was a low diagnostic sensitivity with needle aspiration, nevertheless good response to treatment and favorable outcome were noted. |
|---|---|
| Main Authors: | Judas, Tiago |
| Other Authors: | Namora dos Santos, João |
| Subject: | Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| Year: | 2012 |
| Country: | Portugal |
| Document type: | article |
| Access type: | unknown |
| Associated institution: | Sociedade Portuguesa de Medicina Interna |
| Language: | Portuguese |
| Origin: | Revista Portuguesa de Medicina Interna |
| _version_ | 1869318925168148480 |
|---|---|
| author | Judas, Tiago |
| author2 | Namora dos Santos, João |
| author2_role | author |
| author_facet | Judas, Tiago Namora dos Santos, João |
| author_role | author |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Judas, Tiago\"},{\"Person.name\":\"Namora dos Santos, João\"}] |
| datacite.creators.creator.creatorName.fl_str_mv | Judas, Tiago Namora dos Santos, João |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| datacite.titles.title.fl_str_mv | Liver abscess in an Internal Medicine Department: a retrospective study Abcesso hepático num Serviço de Medicina: estudo retrospectivo |
| dc.creator.none.fl_str_mv | Judas, Tiago Namora dos Santos, João |
| dc.description.none.fl_str_mv | Introdução: O abcesso hepático (AH) é uma patologia pouco frequente, sendo por isso causa rara de internamento hospitalar. Apesar da mortalidade do AH ter diminuído, esta mantém-se ainda consideravelmente elevada. O prognóstico depende do diagnóstico precoce e de uma correcta orientação terapêutica. Objectivos: Estudar os doentes com AH internados num serviço de Medicina durante dez anos. Métodos: Estudo retrospectivo e descritivo efectuado através da consulta da base de dados do Serviço e dos processos clínicos dos doentes. Foram avaliados os factores predisponentes, a forma de apresentação clínica, as alterações laboratoriais, os exames imagiológicos utilizados, os exames microbiológicos e o isolamento do agente patogénico, a terapêutica efectuada e a evolução clínica.Resultados: Num total de 16 doentes com AH, os factores predisponentes mais frequentes foram a cirurgia biliar e abdominal, o etilismo e a diabetes mellitus. A forma de instalação foi geralmente aguda, sendo os achados clínicos mais frequentes febre, calafrios e dor no hipocôndrio direito. Laboratorialmente constatou-se marcada leucocitose com neutrofilia, acentuada elevação da velocidade de sedimentação e da proteína C reactiva, diminuição da albumina sérica, elevação das aminotransferases, da fosfatase alcalina e da gamaglutamil-transpeptidase. A tomografia computadorizada e a ecografia abdominal foram efectuadas na maioria dos doentes. As hemoculturas, efectuadas em todos os doentes, foram positivas em cinco. Os exames serológicos foram positivos em 3 casos. As punções aspirativas, realizadas em metade dos casos, tiveram resultados inconclusivos. Foi efectuada drenagem percutânea em 8 doentes. A antibioterapia foi administrada durante uma média de 33,8 dias, sendo a evolução clínica favorável em 15 doentes e com recidiva em um doente.Conclusões: O perfil dos doentes estudados tinha características sobreponíveis às referidas na literatura científica, sendo no entanto de salientar o isolamento do agente em apenas metade dos casos, a baixa sensibilidade diagnóstica das punções aspirativas mas, por outro lado, a boa resposta à terapêutica bem como uma evolução clínica favorável na maioria dos doentes. |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | https://revista.spmi.pt/index.php/rpmi/article/view/1128 |
| dc.language.none.fl_str_mv | por |
| dc.publisher.none.fl_str_mv | Sociedade Portuguesa de Medicina Interna |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.source.none.fl_str_mv | Medicina Interna; Vol. 19 N.º 1 (2012): Janeiro/ Março; 13-18 2183-9980 0872-671X |
| dc.subject.none.fl_str_mv | Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| dc.title.fl_str_mv | Liver abscess in an Internal Medicine Department: a retrospective study Abcesso hepático num Serviço de Medicina: estudo retrospectivo |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background: Liver abscess (LA) is an uncommon pathology thus a rare cause of hospital admission. Although with a lower mortality, at present, it is still important. Prognosis depends on early diagnosis and correct treatment.Objectives: Evaluate all patients with LA admitted in an Internal Medicine Department for a period of ten years. Methods: retrospective, event driven, clinical database analysis. Risk factors, clinical presentation, laboratory findings, imaging studies were verified as well as microbiology tests, pathogen identification, treatment and clinical evolution.Results: a total of 16 patients with LA were admitted. The most frequent risk factors were biliary and abdominal surgery, alcohol habits and diabetes. Clinical presentation was more frequently acute and common manifestations were fever, chills and right upper quadrant abdominal pain. Most frequent laboratory abnormalities included leukocytosis with neutrophilia, increase on the erythrocyte sedimentation rate and serum C–reactive protein, decrease on albumin and increase on aminotransferases, alkaline phosphatase and gamma glutamyl-transpeptidase. Ultrasound and computed tomography were performed in the majority of patients. Blood cultures, performed in all patients, were positive in five. Serological tests were positive in 3 patients. Needle aspiration was performed in half of the patients, with inconclusive results. Eight patients went through percutaneous catheter drainage. Antibiotics were administered for a mean duration of 33.8 days. There was a good clinical response in 15 patients and one case of recurrence.Conclusions: the profile of our patients with LA was similar to those referred in the literature, however the pathogen identification was only achieved in half of them. There was a low diagnostic sensitivity with needle aspiration, nevertheless good response to treatment and favorable outcome were noted. |
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| identifier.url.fl_str_mv | https://revista.spmi.pt/index.php/rpmi/article/view/1128 |
| inst_facet_str | urn:organizationAcronym:spmi{{{_:::_}}}Sociedade Portuguesa de Medicina Interna |
| instacron_str | SPMI |
| institution | Sociedade Portuguesa de Medicina Interna |
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| oai_identifier_str | oai:oai.revista.spmi.pt:article/1128 |
| organization_str_mv | urn:organizationAcronym:spmi |
| person_str_mv | Judas, Tiago Namora dos Santos, João |
| publishDate | 2012 |
| publisher.none.fl_str_mv | Sociedade Portuguesa de Medicina Interna |
| repo_facet_str | urn:repositoryAcronym:spmi{{{_:::_}}}Revista Portuguesa de Medicina Interna |
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| spelling | en-USLiver abscess in an Internal Medicine Department: a retrospective studypt-PTAbcesso hepático num Serviço de Medicina: estudo retrospectivoJudas, TiagoNamora dos Santos, JoãoAbcesso hepáticopiogénicoamebianoLiver abscesspyogenicamoebichttps://creativecommons.org/licenses/by-nc/4.0http://purl.org/coar/access_right/c_abf2https://revista.spmi.pt/index.php/rpmi/article/view/1128URLoai:oai.revista.spmi.pt:article/1128OAIhttps://revista.spmi.pt/index.php/rpmi/article/view/1128URLhttps://revista.spmi.pt/index.php/rpmi/article/view/1128/762URLHasVersion2012-03-30en-USBackground: Liver abscess (LA) is an uncommon pathology thus a rare cause of hospital admission. Although with a lower mortality, at present, it is still important. Prognosis depends on early diagnosis and correct treatment.Objectives: Evaluate all patients with LA admitted in an Internal Medicine Department for a period of ten years. Methods: retrospective, event driven, clinical database analysis. Risk factors, clinical presentation, laboratory findings, imaging studies were verified as well as microbiology tests, pathogen identification, treatment and clinical evolution.Results: a total of 16 patients with LA were admitted. The most frequent risk factors were biliary and abdominal surgery, alcohol habits and diabetes. Clinical presentation was more frequently acute and common manifestations were fever, chills and right upper quadrant abdominal pain. Most frequent laboratory abnormalities included leukocytosis with neutrophilia, increase on the erythrocyte sedimentation rate and serum C–reactive protein, decrease on albumin and increase on aminotransferases, alkaline phosphatase and gamma glutamyl-transpeptidase. Ultrasound and computed tomography were performed in the majority of patients. Blood cultures, performed in all patients, were positive in five. Serological tests were positive in 3 patients. Needle aspiration was performed in half of the patients, with inconclusive results. Eight patients went through percutaneous catheter drainage. Antibiotics were administered for a mean duration of 33.8 days. There was a good clinical response in 15 patients and one case of recurrence.Conclusions: the profile of our patients with LA was similar to those referred in the literature, however the pathogen identification was only achieved in half of them. There was a low diagnostic sensitivity with needle aspiration, nevertheless good response to treatment and favorable outcome were noted.pt-PTIntrodução: O abcesso hepático (AH) é uma patologia pouco frequente, sendo por isso causa rara de internamento hospitalar. Apesar da mortalidade do AH ter diminuído, esta mantém-se ainda consideravelmente elevada. O prognóstico depende do diagnóstico precoce e de uma correcta orientação terapêutica. Objectivos: Estudar os doentes com AH internados num serviço de Medicina durante dez anos. Métodos: Estudo retrospectivo e descritivo efectuado através da consulta da base de dados do Serviço e dos processos clínicos dos doentes. Foram avaliados os factores predisponentes, a forma de apresentação clínica, as alterações laboratoriais, os exames imagiológicos utilizados, os exames microbiológicos e o isolamento do agente patogénico, a terapêutica efectuada e a evolução clínica.Resultados: Num total de 16 doentes com AH, os factores predisponentes mais frequentes foram a cirurgia biliar e abdominal, o etilismo e a diabetes mellitus. A forma de instalação foi geralmente aguda, sendo os achados clínicos mais frequentes febre, calafrios e dor no hipocôndrio direito. Laboratorialmente constatou-se marcada leucocitose com neutrofilia, acentuada elevação da velocidade de sedimentação e da proteína C reactiva, diminuição da albumina sérica, elevação das aminotransferases, da fosfatase alcalina e da gamaglutamil-transpeptidase. A tomografia computadorizada e a ecografia abdominal foram efectuadas na maioria dos doentes. As hemoculturas, efectuadas em todos os doentes, foram positivas em cinco. Os exames serológicos foram positivos em 3 casos. As punções aspirativas, realizadas em metade dos casos, tiveram resultados inconclusivos. Foi efectuada drenagem percutânea em 8 doentes. A antibioterapia foi administrada durante uma média de 33,8 dias, sendo a evolução clínica favorável em 15 doentes e com recidiva em um doente.Conclusões: O perfil dos doentes estudados tinha características sobreponíveis às referidas na literatura científica, sendo no entanto de salientar o isolamento do agente em apenas metade dos casos, a baixa sensibilidade diagnóstica das punções aspirativas mas, por outro lado, a boa resposta à terapêutica bem como uma evolução clínica favorável na maioria dos doentes.Sociedade Portuguesa de Medicina Internaapplication/pdfpt-PTMedicina Interna; Vol. 19 N.º 1 (2012): Janeiro/ Março; 13-182183-99800872-671Xporjournal articlehttp://purl.org/coar/resource_type/c_6501literatureVoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85 |
| spellingShingle | Liver abscess in an Internal Medicine Department: a retrospective study Judas, Tiago Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| status | SINGLETON |
| status_str | VoR |
| subject.fl_str_mv | Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| title | Liver abscess in an Internal Medicine Department: a retrospective study |
| title_full | Liver abscess in an Internal Medicine Department: a retrospective study |
| title_fullStr | Liver abscess in an Internal Medicine Department: a retrospective study |
| title_full_unstemmed | Liver abscess in an Internal Medicine Department: a retrospective study |
| title_short | Liver abscess in an Internal Medicine Department: a retrospective study |
| title_sort | Liver abscess in an Internal Medicine Department: a retrospective study |
| topic | Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| topic_facet | Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic |
| url | https://revista.spmi.pt/index.php/rpmi/article/view/1128 |
| visible | 1 |