Pyogenic liver abscess: a clinical analysis of 118 cases

Abstract

The clinical data of 118 patients with bacterial liver abscess admitted to a tertiary hospital from January 2007 to December 2009 were analyzed retrospectively. Etiology study showed that 45.8% (54/118) cases of bacterial liver abscess were cryptogenic, 40.7% (48/118) were biliary source and 13.5% (16/118) were hematogenous. The positive rate of pus culture was 57.1% (36/63), among which klebsiella pneumoniae accounted for 72.2% (26/36). The positive rate of blood culture was 31.2% (20/64) and klebsiella pneumoniae accounted for 95% (19/20). One hundred and sixteen patients (98.3%) underwent color ultrasound examination with an accuracy rate of 93.2%. 84 patients (71.2%) underwent the CT scan with an accuracy rate of 95.3% and 20 patients underwent MRI with an accuracy rate of 85%. Seventy five patients (63.6%) accepted ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotic therapy; 40 patients (33.9%) were treated with antibiotics alone. On the discharge 27 patients (22.9%) achieved clinical cure, 87 patients (73.7%) were classified as effective, 4 patients (3.4%) had no effect and no death in this group of patients. The average length of hospital stay was 16 days. Cryptogenic was the most common cause of bacterial liver abscess, biliary source took the second place. Kleibsiella pneumoniae was the predominant organism. Detailed medical history inquiry, physical examination and assistant examination may increase the accuracy rate of diagnosis. Needle biopsy should be performed if necessary. Ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotics should be the first-line treatment. Key words: Liver abscess; Retrospective studies