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Liver abscess in an Internal Medicine Department: a retrospective study

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Resumo: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.
Autores principais:Judas, Tiago
Outros Autores:Namora dos Santos, João
Assunto:Abcesso hepático piogénico amebiano Liver abscess pyogenic amoebic
Ano:2012
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Sociedade Portuguesa de Medicina Interna
Idioma:português
Origem:Revista Portuguesa de Medicina Interna

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