Pyogenic Liver Abscess: Comparison between Single and Multiple Abscesses

Abstract

Background: Pyogenic liver abscess, without treatment, carries a high mortality rate. The purpose of this study was to evaluate the similarities and differences between patients with single and multiple abscesses. Materials and Methods: Thirty-three patients with pyogenic liver abscess who fulfilled the described criteria were studied., Twenty-five had a single abscess and 8 had multiple abscesses. Patient characteristics, underlying disease, clinical manifestations, microbiology, methods of treatment, and outcomes were evaluated and compared between the two groups. Results: In both groups, men predominated and diabetes mellitus was the most common underlying disease. Symptoms and signs were nonspecific; fever, abdominal pain and chills were common. Abscess and blood cultures yielded a higher proportion of monomicrobial pathogens. Klebsiella pneumoniae was the most common isolated organism. The average duration of percutaneous drainage was 13 days and overall success rate of percutaneous treatment was 84%. One patient died and four recurrences were noted in the single abscess group. There were no mortalities in the multiple abscess group. Conclusions: No significant differences were found between the two groups. Early diagnosis and prompt treatment are the prerequisites for cure. The key to early diagnosis is consideration of liver abscess in the differential diagnosis of any unexplained febrile illness with abdominal pain especially in diabetic patients.