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Liver Abscess

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1. Liver abscess

Liver abscess Liver abscess - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Liver abscess Last reviewed: February 2019 Last updated: March 2018 Summary A localised infection in the liver parenchyma that may be bacterial, fungal, or parasitic in origin. Patients typically present with non-specific constitutional symptoms, RUQ abdominal pain, and tenderness. The most common underlying condition in people with pyogenic (...) liver abscess is biliary tract disease. Treatment of pyogenic abscess focuses on both timely administration of broad-spectrum antibiotics and drainage of the abscess. People with fungal abscess require anticandidal therapy. Amoebic abscess is treated with a nitroimidazole, followed by a luminal agent. Definition Liver abscesses are purulent collections in the liver parenchyma that result from bacterial, fungal, or parasitic infection. Infection can spread to the liver through the biliary tree

2018 BMJ Best Practice

2. Hepatic Abscess in a Returning Traveler with Crohn's Disease: Differentiating Amebic from Pyogenic Liver Abscess (PubMed)

Hepatic Abscess in a Returning Traveler with Crohn's Disease: Differentiating Amebic from Pyogenic Liver Abscess Liver abscess is a rare but serious complication of Crohn's disease. Patients with Crohn's disease are at risk for pyogenic liver abscesses due to immunosuppressive therapy, fistulous disease, and intraabdominal abscesses. Inflammatory bowel disease patients are also known to have a greater prevalence of amebiasis compared to the rest of the population; however, a higher incidence (...) of amebic liver abscess has not been reported. We describe a case of a liver abscess in a patient with Crohn's disease that was initially presumed pyogenic but later determined to be amebic in origin. Epidemiology, clinical presentation, diagnosis, and treatment of amebic and pyogenic liver abscesses are discussed.

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2018 Case reports in medicine

3. Maxillary Teeth Abscesses Result in Atypical Liver Abscesses (PubMed)

Maxillary Teeth Abscesses Result in Atypical Liver Abscesses Hepatic liver abscesses are often misdiagnosed on initial presentation because pyogenic liver lesions are a rare occurrence in the United States. This leads to a delay in proper treatment and results in increasing morbidity and mortality. Our case report demonstrates the atypical presentation of a hepatic liver abscess in the elderly. The source of infection was found to be periapical abscesses of the teeth, which subsequently seeded

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2018 Cureus

4. Prevalence of cases of amebic liver abscess in a tertiary care centre in India: A study on risk factors, associated microflora and strain variation of Entamoeba histolytica. (PubMed)

Prevalence of cases of amebic liver abscess in a tertiary care centre in India: A study on risk factors, associated microflora and strain variation of Entamoeba histolytica. Amebiasis, caused by Entamoeba histolytica (E. histolytica), is a significant cause of morbidity and mortality in developing countries. Mortality due to amebiasis is mostly by extra intestinal infections, amebic liver abscess being the most common one. This study was conducted to determine the current epidemiological status (...) , risk factors, associated microflora and strain variation of E. histolytica causing liver abscesses.A total of 115 liver abscess cases comprising of 107 (93%) males and 8 (6.9%) females were included in the study. Microscopic examination of pus samples from the abscesses and species discrimination using nested multiplex PCR showed the presence of E. histolytica in 101 (87.5%) cases. Data collected by face to face interviews using a pre tested questionnaire suggested intake of untreated drinking

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2019 PLoS ONE

5. Correction: Prevalence of cases of amebic liver abscess in a tertiary care centre in India: A study on risk factors, associated microflora and strain variation of Entamoeba histolytica. (PubMed)

Correction: Prevalence of cases of amebic liver abscess in a tertiary care centre in India: A study on risk factors, associated microflora and strain variation of Entamoeba histolytica. [This corrects the article DOI: 10.1371/journal.pone.0214880.].

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2019 PLoS ONE

6. Management of Liver Abscess in Children: Our Experience (PubMed)

Management of Liver Abscess in Children: Our Experience Liver abscess is common in pediatric population in India. Children have unique set of predisposing factors and clinical features. Liver abscesses are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amebic. Its severity depends on the source of the infection and the underlying condition of the patient.A total of 34 patients less than 12 years were assessed in a retrospective study from (...) patients (58.8%) underwent ultrasound-guided percutaneous catheter drainage. Two patients required catheter drainage for large abscess and needle aspiration for the smaller abscess.Antimicrobial therapy along with percutaneous drainage constitutes the mainstay of treatment, whereas open surgical drainage should be reserved for selected cases.How to cite this article: Waghmare M, Shah H, Tiwari C, Khedkar K, Gandhi S. Management of Liver Abscess in Children: Our Experience. Euroasian J Hepato

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2017 Euroasian journal of hepato-gastroenterology

7. Management and Outcome of Liver Abscesses After Liver Transplantation. (PubMed)

Management and Outcome of Liver Abscesses After Liver Transplantation. Liver abscess after orthotopic liver transplantation (OLT) is a rare, life-threatening complication. The aim of this study is to analyze the incidence, risk factors, clinical manifestations, treatment and outcomes of liver abscesses after OLT.We perform a retrospective review of the patients who developed one or more liver abscesses among a series of 984 patients who underwent OLT between January 2000 and December 2016 (...) .Fourteen patients (1.5%) developed 18 episodes of liver abscesses, and the median time from OLT to the diagnosis of liver abscess was 39.7 months. Major predisposing factors were biliary strictures in 11 patients, hepatic artery thrombosis in 8, re-OLT in 3, choledochojejunostomy in 2, living donor OLT in 2, donor after cardiac death in 1, split liver in 1, and liver biopsy in 1. All patients were managed by intravenous antibiotics; percutaneous drainage was performed in 10 patients, while 2 patients

2018 World Journal of Surgery

8. Metastatic endophthalmitis and thyroid abscess complicating Klebsiella pneumoniae liver abscess (PubMed)

Metastatic endophthalmitis and thyroid abscess complicating Klebsiella pneumoniae liver abscess The thyroid is resistant to infection due to its anatomical and physiological characteristics. We present a rare case of invasive liver abscess with metastatic thyroid abscess and endogenous endophthalmitis in a previously healthy 55-year-old female patient without diabetes or other medical illness. This report raises an important question of the virulence of Klebsiella pneumoniae as an increasingly (...) common causative agent of liver abscess.

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2017 Clinical and molecular hepatology

9. Clinical and Genomic Analysis of Liver Abscess-Causing Klebsiella pneumoniae Identifies New Liver Abscess-Associated Virulence Genes (PubMed)

Clinical and Genomic Analysis of Liver Abscess-Causing Klebsiella pneumoniae Identifies New Liver Abscess-Associated Virulence Genes Hypervirulent variants of Klebsiella pneumoniae (hvKp) that cause invasive community-acquired pyogenic liver abscess (PLA) have emerged globally. Little is known about the virulence determinants associated with hvKp, except for the virulence genes rmpA/A2 and siderophores (iroBCD/iucABCD) carried by the pK2044-like large virulence plasmid. Here, we collected most

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2016 Frontiers in cellular and infection microbiology

10. Early predictors for the diagnosis of liver abscess in the emergency department. (PubMed)

Early predictors for the diagnosis of liver abscess in the emergency department. Diagnosing pyogenic liver abscess (PLA) in the emergency department (ED) is challenging due to its non-specific clinical presentation. We aim to identify predictors that aid in diagnosis of PLA in ED patients. This retrospective chart review included patients diagnosed with PLA in a tertiary hospital between January 2008 and December 2012. We compared the demographics, clinical characteristics, investigations

2019 Internal and emergency medicine

11. Comparison of clinical characteristics and outcomes of pyogenic liver abscess patients < 65 years of age versus ≥ 65 years of age. (PubMed)

Comparison of clinical characteristics and outcomes of pyogenic liver abscess patients < 65 years of age versus ≥ 65 years of age. Pyogenic liver abscess (PLA) in the elderly is insufficiently elucidated. A few studies attempted to investigate the role of age in PLA have yielded controversial results. The purpose of this study was to explore the possible differences in the comorbidity, microbiological characteristics and clinical course between elderly and young PLA patients.The clinical

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2019 BMC Infectious Diseases

12. The geriatric nutritional risk index independently predicts adverse outcomes in patients with pyogenic liver abscess. (PubMed)

The geriatric nutritional risk index independently predicts adverse outcomes in patients with pyogenic liver abscess. Geriatric nutritional risk index (GNRI) is a simple and useful nutritional marker for predictor of adverse outcomes in patients undergoing a variety of conditions. This study explored the relationship between GNRI and adverse outcomes of Pyogenic Liver Abscess (PLA) patients and assessed GNRI predictive value.This was one retrospective study involving 240 PLA patients. According

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2019 BMC Geriatrics

13. Meropenem-Vaborbactam as Salvage Therapy for Ceftazidime-Avibactam-Resistant <i>Klebsiella pneumoniae</i> Bacteremia and Abscess in a Liver Transplant Recipient. (PubMed)

Meropenem-Vaborbactam as Salvage Therapy for Ceftazidime-Avibactam-Resistant Klebsiella pneumoniae Bacteremia and Abscess in a Liver Transplant Recipient. We report a case of a 24-year-old liver transplant recipient who developed hepatic artery thrombosis and graft failure, which was complicated by subphrenic abscess and persistent Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bacteremia. Ceftazidime-avibactam treatment led to emergence of resistance, and alternative

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2019 Antimicrobial Agents and Chemotherapy

14. The relation of toddy (palm wine) intake to amoebic liver abscess in a predominantly toddy-drinking population: a cross-sectional study. (PubMed)

The relation of toddy (palm wine) intake to amoebic liver abscess in a predominantly toddy-drinking population: a cross-sectional study. The role of toddy (palm wine) as an independent risk factor for amoebic liver abscess (ALA) is not clear. In a cross-sectional study, the clinico-demographic profiles of inpatients with ALA were examined. Microscopy examination of toddy (n = 43) samples was performed. A total of 198 patients with ALA were enrolled, most of whom were: admitted during the May

2019 Tropical Doctor

15. A cohort study of age and sex specific risk of pyogenic liver abscess incidence in patients with type 2 diabetes mellitus. (PubMed)

A cohort study of age and sex specific risk of pyogenic liver abscess incidence in patients with type 2 diabetes mellitus. To investigate the age-sex-specific incidence and relative risk of pyogenic liver abscess (PLA) in patients with type 2 diabetes mellitus (T2DM), and to assess the joint effects of T2DM and other clinical risk factors for PLA on PLA incidence. We used a population-based cohort design with Taiwan's National Health Insurance claim data. Study subjects included 613,921 T2DM (...) significantly modify the relationship between T2DM and PLA, with a higher HR noted in males patients and those aged <45 years. Biliary tract diseases (HR, 8.60; 95% CI, 7.87-9.40) and liver cirrhosis (HR, 7.52; 95% CI, 6.58-8.59) may add substantially additional risk to the incidence of PLA in T2DM patients. The increased risk of PLA in T2DM was greater in male and younger patients. Careful management of biliary tract diseases and liver cirrhosis may also help reduce the incidence of PLA in T2DM patients.

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2019 Medicine

16. Transition to Oral versus Continued Intravenous Antibiotics for Patients with Pyogenic Liver Abscesses: A Retrospective Analysis. (PubMed)

Transition to Oral versus Continued Intravenous Antibiotics for Patients with Pyogenic Liver Abscesses: A Retrospective Analysis. The management of pyogenic liver abscesses usually requires 4 weeks of antibiotic therapy. It is unknown if oral (PO) antibiotics are as effective as intravenous (IV) antibiotics for this indication.To compare 30-, 60-, and 90-day readmission rates between patients with pyogenic liver abscesses receiving IV antibiotics for the duration of therapy and those who were (...) transitioned to PO antibiotics after discharge from the hospital.This retrospective study included patients with pyogenic liver abscesses who had undergone percutaneous drainage and received IV antibiotics while in the hospital. Patients were grouped based on receipt of either PO or IV antibiotics at discharge.The final cohort resulted in 99 patients, 48 in the PO group and 51 in the IV group. The most common organisms identified were Klebsiella sp, Escherichia coli, and Streptococcus sp. The most common

2019 Pharmacotherapy

17. Case Report: Spontaneous Resolution of Intracavitary Hepatic Artery Pseudoaneurysm Caused by Amebic Liver Abscess following Percutaneous Drainage. (PubMed)

Case Report: Spontaneous Resolution of Intracavitary Hepatic Artery Pseudoaneurysm Caused by Amebic Liver Abscess following Percutaneous Drainage. Intrahepatic pseudoaneurysm (IHPA) is generally iatrogenic, and it warrants urgent management because of its reportedly significant risk of rupture leading to considerable mortality. Intrahepatic pseudoaneurysm caused by amebic liver abscess (ALA) is exceedingly rare with fewer than seven published reports. All reported symptomatic cases have been (...) treated with hepatic artery embolization; therefore, little is known about its natural course and effect of abscess drainage on its outcome. We report the first case of symptomatic intracavitary IHPA caused by ALA in which ultrasound-guided percutaneous catheter drainage of the abscess resulted in the spontaneous resolution of the IHPA.

2019 American Journal of Tropical Medicine & Hygiene

18. Prognosis of liver abscess with no identified organism. (PubMed)

Prognosis of liver abscess with no identified organism. There are limited studies focusing on liver abscess with negative microbiological cultures. This study evaluated the clinical and prognostic differences of patients with culture-negative liver abscess (CNLA) compared to those with a positive culture (CPLA) and compared these factors between K. pneumoniae liver abscess (KLA) and E. coli liver abscess (ELA).A retrospective study of the patients who admitted with a liver abscess at two (...) tertiary hospitals in Korea from 2012 to 2016 was performed.Among a total of 402 patients with liver abscess, 61.2% had positive cultures. K. pneumoniae (n = 133) was the most common cause, followed by E. coli (n = 74). Patients with CPLA were significantly older (p = 0.02) and more frequently had cholelithiasis or biliary tract disease (p = 0.001) compared to patients with CNLA. In-hospital mortality (p = 0.63) and recurrence (p = 0.77) were no different between the two groups. The length of hospital

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2019 BMC Infectious Diseases

19. Clinical characteristics and treatment outcomes in a cohort of patients with pyogenic and amoebic liver abscess. (PubMed)

Clinical characteristics and treatment outcomes in a cohort of patients with pyogenic and amoebic liver abscess. We describe the clinical features of a cohort of patients with liver abscesses and investigate relationships between clinical, radiological and microbiological findings and mortality.Retrospective review of pyogenic (PLA) or amoebic liver abscesses (ALA) diagnosed and treated at a major infectious diseases department in London over 9 years.One hundred forty-one patient records were (...) identified; 132 (93.6%) had PLA and 9 (6.4%) ALA. No organism was identified in 38.6% (51/132); a single bacterial species was isolated in 47.0% (62/132) of PLA, ≥ 2 in 14.4% (19/132). There was weak evidence of variation in abscess size by type of microorganism, with streptococcal PLA typically larger (p = 0.03 for Streptococcus milleri group, p = 0.05 for non-milleri streptococci). Patients with ALA were younger (median 41, IQR 37-51 years) than those with PLA (median 68, IQR 50.5-78 years) (p = 0.003

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2019 BMC Infectious Diseases

20. Liver abscess caused by ingestion of fishbone: A case report. (PubMed)

Liver abscess caused by ingestion of fishbone: A case report. The penetration of a foreign body through the stomach wall and causing liver abscess is rare. A case of liver abscess caused by secondary bacterial infection was reported in the current study.A 58-year-old male patient had a history of eating fish and presented with recurrent fever with chills. The patient had a previous fever for 9 days without any obvious inducement and the highest body temperature rose to 40.8°C, along with fear (...) of cold and chills. Body temperature declined to normal value after 5 days of infusion treatment (drugs were unknown) in the local clinic. Two days afterward, his body temperature again rose to 40.3°C at its highest.Abdominal computed tomography (CT) showed that there was a quasicircular low-density focus in the left hepatic lobe which was most likely a liver abscess. A dense strip was found in proximity to the left hepatic lobe, implying the retention of a catheter in the upper abdominal cavity

2019 Medicine

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