Pathology of Pyogenic Liver Abscess in Children

1999 ◽  
Vol 2 (6) ◽  
pp. 537-543 ◽  
Author(s):  
Fausto E.L. Pereira ◽  
Carlos Musso ◽  
Jane S. Castelo
Keyword(s):  
Liver Abscess ◽  
Liver Tissue ◽  
Penetrating Trauma ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Larva Migrans ◽  
Morphological Evidence ◽  
Predisposing Factor ◽  
The Right

Little is known about preexisting lesions in livers of children with pyogenic liver abscess (PLA). Study of these lesions may elucidate possible predisposing factors for the disease. In Vitória, state of Espirito Santo, Brazil, PLA in children is frequently associated with helminthic infections and eosinophilia. We hypothesize that nematode infection with larvae migrating through the liver is a predisposing factor for PLA, because the infection induces immunomodulation and likely trapping of bacteria in liver granulomas. In this report, we describe observations of 22 cases of PLA in children studied at autopsy (16 cases) or in surgical biopsies (6 cases), including 17 boys and 5 girls ranging in age from 1 to 13 years (mean 4.6 years, median 3.5 years). Multiple abscesses in both lobes were found in 13 cases and a single abscess was found in the right lobe in 10 cases. All cases showed histologically classical pyogenic inflammation without morphological evidence of amoebiasis. In six cases there were granulomas similar to those caused by larva migrans visceralis (from Toxocara or other nematodes) in liver tissue not affected by the abscess. Nematode antigens in central areas of necrosis of granuloma in all six cases and fragments of a larva, possibly of Toxocara, were found on samples immunohistochemically stained with polyclonal anti- Toxocara antibodies. There were numerous eosinophils in abscesses with Charcot-Leyden crystals. Eosinophils were found frequently in portal triads far from the abscess wall. In four cases, in which bile duct ascariasis was found, worms were noted in the bile ducts, and eggs were found in liver parenchyma surrounding the abscess in two cases. Foreign-body granulomas were found in one case in which penetrating trauma was the cause of abscess. In one case there was one histiocytic granuloma whose origin was not determined. The observation of six cases of granuloma similar to larva migrans visceralis (or produced by other nematode larva) in liver tissue not directly affected by the abscess supports the hypothesis that helminth infections with larva migrating through the liver are a predisposing factor for pyogenic hepatic abscess in children.

scholarly journals Puerperal sepsis caused by liver abscess: case report

2017 ◽  
Vol 17 (4) ◽  
pp. 853-858
Author(s):  
Flávio Xavier Silva ◽  
Alex Sandro Rolland Souza
Keyword(s):  
Intensive Care ◽  
Liver Abscess ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Good Health ◽  
Recurrent Pain ◽  
Laboratory Findings ◽  
The Right

Abstract Introduction: sepsis is a serious public health problem, affecting millions of people in the world each year, with a high mortality rate (one out of four patients) and an increasing incidence. Sepsis is one of the main causes of maternal mortality and an important cause of admission to obstetric intensive care units. Case description: In this study, the authors report the case of a woman having been submitted to cesarean section three days before presenting clinical signs of sepsis and septic shock caused by a liver abscess. The patient had a set of complications secondary to shock, such as thrombocytopenia, coagulopathy, toe ischemia and acute kidney failure. The patient had cholelithiasis and recurrent pain in the right hypochondrium during pregnancy. During hospitalization, the mechanism involved in the development of hepatic abscess was infection of the biliary tract. The patient was treated in an obstetric intensive care unit with antibiotics and drainage of the liver abscess. Progress was favorable and the patient was discharged in good health. Discussion: pyogenic liver abscess during pregnancy and puerperium is a serious condition which represents a diagnostic and therapeutic challenge, with few cases reported. The normally nonspecific clinical and laboratory findings can lead to a late diagnosis, which increases the risk of maternal morbidity and mortality.

scholarly journals Pyogenic liver abscess caused by Gemella morbillorum

2014 ◽  
pp. 81-84 ◽  
Author(s):  
Paolo Borro ◽  
Alessandro Sumberaz ◽  
Gianni Testino
Keyword(s):  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Pleural Empyema ◽  
Abdominal Ultrasound ◽  
Needle Aspiration ◽  
Focal Lesions ◽  
Simple Cyst ◽  
Systemic Antibiotic Therapy ◽  
The Right

Even though Gemella morbillorum infection (GMI) is rare in humans, it may, nevertheless, cause endocarditis, meningitis, brain abscess, pleural empyema, nephritis, mediastinitis, and – occasionally – liver abscess. We are describing the case of a 64-year-old Caucasian male admitted with fever and abdominal pain. Laboratory parameters revealed inflammation signs, and instrumental examinations showed the presence of diverticula in the ascending colon. Abdominal ultrasound (US) and computer tomography (CT) showed two focal lesions in the right liver lobe. One had the characteristics of a simple cyst; the second was hypoechoic with a low density area, possibly containing necrotic material. US-guided needle biopsy was found negative for neoplastic cells, showing purulent infiltrate. Pus culture was found positive for GMI. Systemic antibiotic therapy, coupled with repeated US-guided needle aspiration, induced the resolution of the hepatic abscess. Few cases have been reported of hepatic abscess caused by GMI in immunocompetent non-cirrhotic subjects.

scholarly journals Ruptured Liver Abscess in Neonates: Report of Two Cases

2016 ◽  
Vol 5 (3) ◽  
pp. 31 ◽  
Author(s):  
Niyaz Ahmed Khan ◽  
SR Choudhury ◽  
Praveen Jhanwar
Keyword(s):  
Rare Disease ◽  
Liver Abscess ◽  
Abdominal Mass ◽  
Hepatic Abscess ◽  
Predisposing Factor ◽  
Term Neonates ◽  
Umbilical Catheterisation

Neonatal hepatic abscess is a rare disease seen mainly in preterm following umbilical catheterisation. Liver abscess in term neonates without any predisposing factor is still rarer and only few cases have been reported in the literature. Here we report two cases of liver abscess in term neonates presenting with abdominal mass due to rupture.

scholarly journals Evaluation of clinical risk factors for developing pleural empyema secondary to liver abscess

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Eunjue Yi ◽  
Tae Hyung Kim ◽  
Jun Hee Lee ◽  
Jae Ho Chung ◽  
Sungho Lee
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Liver Abscess ◽  
Biliary Tract ◽  
Clinical Manifestation ◽  
Pyogenic Liver Abscess ◽  
Pleural Empyema ◽  
Patient Characteristics ◽  
Group 2 ◽  
The Right

Abstract Background The aim of this study was to investigate the clinical manifestation and predictive risk factors of pleural empyema developing during treatment of the pyogenic liver abscess. Methods Medical records of patients with the liver abscess in our institution were reviewed retrospectively. Enrolled patients were classified into four groups; Group 1: patients without pleural effusion, Group 2: patients with pleural effusion and who were treated noninvasively, Group 3: patient with pleural effusion and who were treated with thoracentesis, and Group 4: patients with pleural effusion that developed into empyema. Patient characteristics, clinical manifestation, and possible risk factors in development of empyema were analyzed. Results A total of 234 patients was enrolled in this study. The incidence rate of empyema was 4.27% (10 patients). The mean interval for developing pleural effusion was 5.6 ± 6.35 days. In multivariate analysis, risk factors for developing pleural effusion included the location of the liver abscess near the right diaphragm (segment 7 and 8, OR = 2.30, p = 0.048), and larger diameter of the liver abscess (OR = 1.02, p = 0.042). Among patients who developed pleural effusions, presences of mixed microorganisms from culture of liver aspirates (OR = 10.62, p = 0.044), bilateral pleural effusion (OR = 46.72, p = 0.012) and combined biliary tract inflammation (OR = 21.05, p = 0.040) were significantly associated with the need for invasive intervention including surgery on effusion. Conclusion The location of the liver abscess as well as pleural effusion, elevated inflammatory markers, and combined biliary tract inflammation may be important markers of developing pleural complication in patients with pyogenic liver abscess.

scholarly journals HEPATECTOMY FOR PYOGENIC LIVER ABSCESS TREATMENT: EXCEPTION APPROACH?

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
Sergio Renato PAIS-COSTA ◽  
Sergio Luiz Melo ARAUJO ◽  
Victor Netto FIGUEIREDO
Keyword(s):  
Liver Abscess ◽  
Percutaneous Drainage ◽  
Therapeutic Option ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Surgical Approaches ◽  
Morbidity Rate ◽  
Median Hospital Stay ◽  
The Mean

ABSTRACT Background: Percutaneous drainage for pyogenic liver abscess has been considered the gold-standard approach for the treatment on almost of the cases. However, when percutaneous drainage fails or even in some especial situations, as multiloculate abscess, lobe or segment surgical resection can solve infectious clinical condition. Aim: To report a series of patients who underwent hepatectomy for pyogenic liver abscess performed by a single surgical team. Methods: Eleven patients were operated with ages ranging from 45-73 years (mean and median 66 years). There were eight men and three women. The etiologies were: idiopathic (n=4), biliary (n=2), radiofrequency (n=2), direct extension (n=1), portal (n=1), and arterial (n=1). The mean lesion diameter was 9.27 cm (6-20 cm). Results: The mean operation length was 180 min (120-300). The mean intra-operative blood loss was 448 ml (50-1500). Surgical approaches were: right hepatectomy (n=4), left hepatectomy (n=3), left lateral sectioniectomy (n=1), right posterior sectioniectomy (n=2), resection of S8 (n=1), and S1 (n=1). Postoperative morbidity rate was 30%, while mortality was null. Median hospital stay was 18 days (5-45). The median follow-up period was 49 months (13-78). There was single lesion recurrence. Conclusion: Hepatectomy can be done as exception approach for pyogenic hepatic abscess treatment; it is a good therapeutic option in special situations.

Surgical treatment of combined thoraco-abdominal injury of liver with the mechanism of the hydrodynamic shock (case report)

2017 ◽  
Vol 86 (3) ◽  
pp. 240
Author(s):  
Ievgen Tsema ◽  
Igor Khomenko ◽  
Vitalii Shapovalov ◽  
Georgii Makarov ◽  
Roman Palytsia ◽  
...  
Keyword(s):  
Medical Care ◽  
Damage Control ◽  
Abdominal Cavity ◽  
Penetrating Trauma ◽  
Liver Parenchyma ◽  
Clear Understanding ◽  
Medical Evacuation ◽  
Post Traumatic ◽  
The Right ◽  
Vascular Suture

This article presents a clinical case of successful multilevel treatment the combined gunshot wound of liver with the mechanism of hydrodynamic shock using «damage control» tactic. The patient received a combined thoraco‑abdominal injured as a result of warfare on the east of Ukraine. The blind fragmental penetrating trauma of the chest cavity led to the rupture of the right dome of diaphragm and liver (S3–S6) by the mechanism of hydrodynamic kick (fragments the wreckage and input/output openings in the abdominal cavity were not found). The «damage control» tactic was implemented as follows. On the second level of medical care the rupture of the liver parenchyma eliminated by repeated firmwares with omentopexy. The post‑traumatic period proceeded with the several consecutive complications: cutting the liver sutures, the arrosive bleeding from the right hepatic artery and the irreversible ischemia of the liver S5-S6. These complications were liquidated gradually on the IV level of medical care by the transpupillary choledochal stenting, vascular suture and the imposition of a typical anatomical resection of liver S5–6. Successful treatment of patients with the severe fragmental gunshot thoraco‑abdominal injuries should be based on a clear understanding of the stages of traumatic disease and expected complications of parallel conduct medical evacuation, using «damage control» tactic on the all levels of medical care.

scholarly journals Management of Fish Bone-Induced Liver Abscess with Foreign Body Left In Situ

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Ryan Burkholder ◽  
Hrishikesh Samant
Keyword(s):  
Foreign Body ◽  
Liver Abscess ◽  
Rare Case ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Fish Bone ◽  
Interesting Case ◽  
Liver Lobe ◽  
Left Liver Lobe

Pyogenic liver abscess, having experienced an evolving pathogenesis over the years, still remains a serious problem with significant morbidity. Iatrogenic and ascending biliary infections are the most common known etiologies for hepatic abscess. Here we report an interesting case of an elderly lady admitted with abdominal pain due to a pyogenic liver abscess in the left liver lobe which was attributed to perforation by an ingested fish bone. The authors also reviewed literature for management for this rare case as there are no standard guidelines. Our patient was successfully treated with antibiotics and percutaneous drainage with foreign body left in situ.

scholarly journals ABSES HATI PIOGENIK

2012 ◽  
Vol 36 (1) ◽  
pp. 106
Author(s):  
Yusri Dianne Jurnalis ◽  
Delfican Delfican ◽  
Yorva Sayoeti
Keyword(s):  
Liver Abscess ◽  
Clinical Symptoms ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Surgical Drainage ◽  
Percutaneous Aspiration ◽  
High Grade Fever ◽  
Threatening Condition ◽  
Upper Abdominal ◽  
The Right

AbstrakAbses hati piogenik merupakan suatu kondisi yang berat dan mengancam kehidupan dengan angka mortalitas yang tinggi sehingga membutuhkan diagnostik dan terapi yang akurat. Gejala yang paling sering ditemukan adalah nyeri perut bagian atas, hepatomegali, demam tinggi, mual dan muntah. Gejala ini bervariasi sesuai ukuran abses, keadaan umum pasien, adanya penyakit dasar dan komplikasi. Pada sebagian besar kasus, penyakit dasarnya tidak diketahui. Abses biasanya soliter dan terletak di lobus kanan hati. USG dan CT scan abdomen merupakan sarana diagnostik utama. Abses hati piogenik diterapi dengan aspirasi perkutaneus bersamaan dengan antibiotik. Jika gagal, drainase dengan pembedahan dibutuhkan. Dengan adanya terapi invasif yang minimal seperti aspirasi jarum perkutaneus atau drainase kateter yang dipandu secara radiologis serta ketersediaan antibiotik berspektrum luas, pasien jarang membutuhkan tindakan pembedahan saat ini.Kata kunci : abses hati piogenik, aspirasi perkutaneus, drainase bedahAbstractPyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The most common presenting clinical symptoms are upper abdominal pain, tenderness, hepatomegaly, high-grade fever, nausea and vomiting. These features are variable depending upon the size of the abscess, general health of the patient, associated diseases and complications. In majority of the cases, the underlying cause could not be identified. Majority of abscesses are solitary and are noted in the right lobe of liver. USG and CT of the abdomen are the main tools of diagnosis. PLAs are mainly treated by percutaneous aspiration under antibiotic cover. If fails, surgical drainage becomes necessary. However, with the advent of minimally invasive therapy such as image-guided percutaneous needle aspiration or catheter drainage and the availability of broadspectrum antibiotics, patients with PLA nowadays seldom require open surgery for treatment.Key word : pyogenic liver abscess, percutaneous aspiration, surgical drainage

scholarly journals A retrospective analysis of pyogenic liver abscess and antibiotic resistivity of common pathogens in Peshawar

2020 ◽  
Vol 7 (12) ◽  
pp. 4190-4196
Author(s):  
Nadia Bashir ◽  
Muhammad Adnan Shereen ◽  
Abeer Kazmi ◽  
Muhammad Sajid ◽  
Hafiz Ullah
Keyword(s):  
Liver Abscess ◽  
Demographic Data ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Biochemical Tests ◽  
Female Ratio ◽  
Male Predominance ◽  
Demographic Study ◽  
Life Threatening ◽  
Sensitivity Rate

Background: Pyogenic liver abscess (PLA) is a rare but life-threatening disease, with a frequency ranging from 10.83 to 17.45 per 100,000 persons. The major cause of PLA is bacterial infection of liver parenchyma. The present research study was designed to investigate the common microbes causing PLA in Peshawar (Pakistan) and to evaluate a variety of the most capable and efficient antibiotics for treatment of PLA. Methods: A 7-year (2012 - 2018) retrospective demographic study of medical records of all PLA patients (n = 379) admitted to the Hayatabad Medical Complex (HMC) and Khyber Teaching Hospital (KTH) was initially performed. The demographic study was followed by biochemical tests and antibiotic resistivity tests of microorganisms, isolated from available samples and selected from literature using web services. Results & Conclusion: The demographic data revealed that 70% of the PLA patients were under the age of 50, with male predominance (male to female ratio of 3:1). It was concluded that K. pneumonia, poly-microbes (K. pneumonia and Citrobacter), and E. coli are the most common microbes involved in causing PLA in the population of Peshawar. E.coli, Citrobacter and K. pneumonia were sensitive to Cefixime and Ciprofloxacin (100% sensitivity rate), but showed significant resistance against Amoxycillin, Oxacillin and Fusidic Acid. It is, therefore, prudent to practice susceptibility-directed antibiotic therapy.

Endogenous Endophthalmitis Associated with Pyogenic Liver Abscess Caused by Klebsiella Pneumoniae: A Case Report

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Wael Ferjaoui ◽  
Mohamed Hajri ◽  
Souhail Karwiya ◽  
Seifeddine Baccouche ◽  
Sahir Omrani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Exceptional Case ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Percutaneous Transhepatic Drainage ◽  
Transhepatic Drainage

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

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