Liver abscess in an Internal Medicine Department: a retrospective study

Abstract

Background: Liver abscess (LA) is an uncommon pathology thus
a rare cause of hospital admission. Although with a lower mortality, at present, it is still important. Prognosis depends on early
diagnosis and correct treatment.
Objectives: Evaluate all patients with LA admitted in an Internal
Medicine Department for a period of ten years.
Methods: retrospective, event driven, clinical database analysis.
Risk factors, clinical presentation, laboratory findings, imaging
studies were verified as well as microbiology tests, pathogen
identification, treatment and clinical evolution.
Results: a total of 16 patients with LA were admitted. The most
frequent risk factors were biliary and abdominal surgery, alcohol
habits and diabetes. Clinical presentation was more frequently
acute and common manifestations were fever, chills and right
upper quadrant abdominal pain. Most frequent laboratory abnormalities included leukocytosis with neutrophilia, increase on
the erythrocyte sedimentation rate and serum C–reactive protein,
decrease on albumin and increase on aminotransferases, alkaline
phosphatase and gamma glutamyl-transpeptidase. Ultrasound
and computed tomography were performed in the majority of
patients. Blood cultures, performed in all patients, were positive in
five. Serological tests were positive in 3 patients. Needle aspiration
was performed in half of the patients, with inconclusive results.
Eight patients went through percutaneous catheter drainage.
Antibiotics were administered for a mean duration of 33.8 days.
There was a good clinical response in 15 patients and one case
of recurrence.
Conclusions: the profile of our patients with LA was similar to
those referred in the literature, however the pathogen identification
was only achieved in half of them. There was a low diagnostic
sensitivity with needle aspiration, nevertheless good response to
treatment and favorable outcome were noted.