Background: Pyogenic liver abscesses (PLA) are frequent in immunosuppressed patients. We review the characteristics of patients with PLA at a tertiary academic Spanish hospital in Asturias.
Methods: A retrospective observational study for 10 years, between 2006-2015. Epidemiological, clinical, analytical characteristics, treatment and hospital stay of the patients with PLA were analyzed.
Results: 99 patients, 62 (62.6%) men, with age ≥65 years (72.7%). The most frequent etiology was: Biliary (40%), postsurgical (15%) and intestinal origin (11%). The most frequent clinical signs were fever, showing significant differences, abdominal pain (p=0.001) and nausea (p=0.02) between biliary PLA and the rest of the PLA. Microbiological results were confirmed in 63% (62 cases). All were treated with antibiotic therapy, along with percutaneous drainage (44.4% (44 cases)); and surgical drainage (12.1% (12 cases)). The overall mean stay was 23.1 days without significant differences between those treated with percutaneous drainage or surgical drainage.
Conclusion: PLA predominate in patients ≥65 years. Biliary PLA are the most frequent, diagnosed at an older age than the intestinal PLA (p=0.005).
- The treatment is based on systemic antibiotherapy and percutaneous drainage, especially in PLA only >5cm (p=0.019).
- There are no significant differences in average stay of patients treated with percutaneous drainage or surgical drainage.
Nieto Piñar Yasmina, Hernández González Verónica Lisseth and Borges SA Marcio*
Published on: 20th September, 2022
Hepatic Actinomycosis (HA) is a very rare abdominal actinomycosis that can be confused with hepatic involvement due to a tumor. Liver involvement can occur from an abdominal focus or by blood dissemination from another focus. This disease is much more common in men between 50 - 70 years and in a situation of immunosuppression. Symptoms are nonspecific and diagnosis includes histopathology, cultures, and imaging test. Treatment includes prolonged antibiotic therapy with antibiotics such as penicillin and drainage of abscesses.We present a case of a 54-year-old man patient with a record of three years of chronic pancreatitis of probably alcoholic origin, who developed hepatic actinomycosis, requiring drainage of liver abscesses and directed antibiotic treatment.
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