P0363 LIVER ABSCESS IN CHILDREN - A SINGLE INSTITUTIONAL EXPERIENCE IN SOUTHERN TAIWAN

Abstract

Introduction: Liver abscess is uncommon in children. It often develops in immunocompromised patients, especially those with chronic granulomatous disease and leukemia. The purpose of this study is to evaluate the predisposing factors, pathogens, and the managements of liver abscess in children. Methods: From 1986 to 2001, fifteen children were admitted to our hospital under the diagnosis of liver abscess. All medical records were reviewed. Age, sex, symptoms and signs, laboratory data, and associated diseases were noted. Imaging finding, pathogens, managements, and duration of hospitalization were recorded. Prolonged fever was defined as fever for 7 days or longer before the diagnosis of liver abscess. Results: Thirteen cases were older than 8 years old and two were younger than one year old. Fever (15/15, 100%) and abdominal pain (13/15, 87%) were the most common symptoms. Twelve patients (80%) had prolonged fever. Eleven (73%) cases were cryptogenic in origin. Most of the microorganisms were obtained solely from cultures of pus. Klebsiella pneumoniae was the most common organism isolated (6/15, 40 %). Beside antibiotics, percutaneous catheter drainage (PCD) was performed in 11 patients (73%), only one underwent surgical intervention due to poor response to PCD management. All of our patients were survival after at least one-year follow-up. Conclusion: Liver abscess should be suspected in the patients with prolonged fever of unknown origin and abdominal pain. PCD combined with adequate antibiotic was sufficient for therapy of liver abscess in most cases. K. pneumoniae was the most common isolated pathogen in the Southern Taiwan.