1/20. Pyogenic liver abscess with a focus on klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics.OBJECTIVES: Pyogenic liver abscess is a common intraabdominal infection. Historically, escherichia coli (E. coli) has been the predominant causative agent. Klebsiella liver abscess (KLA) was first reported in taiwan and has surpassed E. coli as the number one isolate from patients with hepatic abscesses in that country and reports from other countries, including the united states, have increased. We examined the microbiologic trends of pyogenic liver abscess at our institution to determine if a similar shift in etiologic agents was occurring. methods: We examined all cases of liver abscess at our institution from 1999 to 2003 via a retrospective chart review of inpatient records and reviewed the English literature via a medline search for all U.S. cases of KLA. RESULTS: Since 1966, only 12 cases of KLA have been reported in the united states. We report six cases of KLA at our institution alone; 2 patients were not Asian, and 4 were not diabetic. klebsiella pneumoniae (K. pneumoniae) was the most common cause of pyogenic hepatic abscess at our institution over the last 5-yr period. When comparing Klebsiella versus other causes of pyogenic liver abscess, there were no significant differences in demographics or laboratory findings; however, most of our Klebsiella cases occurred among Filipinos. review of the 18 cases of K. pneumoniae liver abscess in the united states showed that Klebsiella cases occurred predominantly among middle-aged men; 83% had concurrent bacteremia and 28% had metastatic complications. An increasing number of cases were reported from the united states since the mid-1990s. CONCLUSIONS: These data suggest that KLA may represent an emerging disease in Western countries, such as the united states. The diagnosis of K. pneumoniae should be considered in all cases of liver abscess, and appropriate antibiotic therapy and a diagnostic work-up for metastatic complications should be employed.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/20. Pyogenic liver abscess due to rhodococcus equi in an immunocompetent host.A case of pyogenic liver abscess (PLA) due to rhodococcus equi in an immunocompetent individual was successfully treated by combining surgery and antibiotics. The R. equi-targeted antimicrobial agents erythromycin and rifampin were used only after surgical resection of the lesion and identification of the infective organism.- - - - - - - - - - ranking = 0.38461538461538keywords = abscess (Clic here for more details about this article) |
3/20. Pyogenic hepatic abscess after percutaneous liver biopsy in a patient with sickle cell disease.liver abscess is a rare complication of liver biopsy but has not been reported in a patient with sickle cell disease (SCD) undergoing this procedure. The authors report the case of a child with SCD, on treatment with chronic transfusions and desferrioxamine, who developed a delayed liver abscess after a liver biopsy in which Avitene, a topical hemostatic agent, was used. This is the first description of a liver abscess as a possible complication of liver biopsy in a child with SCD. The presence of a hepatic abscess should be considered in the differential diagnosis of atypical abdominal pain in patients with SCD.- - - - - - - - - - ranking = 0.61538461538462keywords = abscess (Clic here for more details about this article) |
4/20. Favourable outcome of multiple pyogenic liver abscesses with conservative treatment.We describe a patient with multiple pyogenic liver abscesses treated only with antibiotics with a favourable outcome. This conservative treatment may be an option in some patients with multiple pyogenic liver abscesses.- - - - - - - - - - ranking = 0.46153846153846keywords = abscess (Clic here for more details about this article) |
5/20. Lemierre's syndrome: porphyromonas asaccharolytica as a putative pathogen.A case of Lemierre's syndrome is reported in which metastatic abscesses resulted from septic thrombophlebitis of the internal jugular vein secondary to bacterial pharyngitis. A 32-year-old male suffering from a painful left-sided neck mass, sore throat, and fever was admitted to our hospital. Computed tomography revealed thrombosis of the left internal jugular vein, septic pulmonary emboli, and a liver abscess. blood culture showed porphyromonas asaccharolytica. Although empyema occurred transiently during the treatment, the patient recovered following prolonged antimicrobial therapy. Although fusobacterium species are a well-known cause of Lemierre's syndrome, cases in whom porphyromonas species was isolated have scarcely been reported. Moreover, case reports from japan have been few.- - - - - - - - - - ranking = 0.15384615384615keywords = abscess (Clic here for more details about this article) |
6/20. Solitary liver abscess in a healthy child presenting with fever of unknown origin.Pyogenic liver abscess is rarely encountered in normal children. We report a case of solitary pyogenic liver abscess in a healthy child aged 8 months. He presented with fever of unknown origin and mild hepatomegaly. Full recovery was achieved by surgical intervention and prolonged antibiotic treatment. Management and recommended treatment in children with liver abscess are presented.- - - - - - - - - - ranking = 0.53846153846154keywords = abscess (Clic here for more details about this article) |
7/20. Pyogenic liver abscess in patients with schistosomiasis mansoni.schistosomiasis mansoni has been described as a predisposing factor for pyogenic liver abscess formation. Previous experimental studies have shown that acute schistosomiasis concurrent with staphylococcus aureus bacteremia favors the colonization of the liver by the bacteria, and subsequent pyogenic liver abscess formation. In addition, clinical studies and case reports have demonstrated the association of schistosomiasis mansoni with pyogenic liver abscesses. We describe a Brazilian patient with chronic schistosomiasis mansoni who developed recurrent pyogenic liver abscesses due to pseudomonas aeruginosa. The authors review the clinical, diagnostic and treatment aspects of patients with schistosomiasis and pyogenic liver abscess reported in the medical literature.- - - - - - - - - - ranking = 0.69230769230769keywords = abscess (Clic here for more details about this article) |
8/20. Acute budd-chiari syndrome resulting from a pyogenic liver abscess.budd-chiari syndrome is a rare condition resulting from outflow obstruction of the liver. This syndrome due to a pyogenic abscess is rarely documented in the English literature. Here a male patient with acute Budd Chiari syndrome is presented. A 21-year-old male patient was admitted to the hospital because of severe right upper quadrant pain, jaundice, hepatomegaly and fever. The examination of liver by computerized tomography and ultrasound revealed a large lesion 120 x l00 mm in size located in the right lobe of liver, which was compressing the inferior vena cava, the right and middle hepatic veins. Twenty-three days after percutaneous catheter drainage and medical treatment, the patient was discharged with complete healing. Although many disorders including malignant diseases can cause budd-chiari syndrome, a pyogenic liver abscess compressing the inferior vena cava, and hepatic veins leading to acute budd-chiari syndrome has been rarely reported in English medical literature. patients presenting with abdominal pain, hepatomegaly, and ascites should be carefully evaluated from this point of view.- - - - - - - - - - ranking = 0.46153846153846keywords = abscess (Clic here for more details about this article) |
9/20. Staphylococcal liver abscess and acute cholecystitis in a patient with Crohn's disease receiving infliximab.We present an unusual case of empyema of the gallbladder associated with a pyogenic liver abscess in a patient with Crohn's disease on Infliximab. It manifested by weakness, weight loss, and vague abdominal pain, which eventually localized to the right upper quadrant 4 days prior to admission. Diagnostic evaluation, which included ultrasonography and computed tomography, revealed cholelithiasis, gallbladder wall thickening, and a low-attenuation, complex mass in the left hepatic lobe. cholecystectomy and open drainage of the liver abscess were successfully performed. There are few reports of intrahepatic abscess associated with Crohn's disease. The relationship between acute cholecystitis and Crohn's disease has also been documented. However, this report documents the unusual complication of pyogenic liver abscess secondary to acute cholecystitis in the unique population of Crohn's disease patients on Infliximab.- - - - - - - - - - ranking = 0.61538461538462keywords = abscess (Clic here for more details about this article) |
10/20. thrombophlebitis of the hepatic veins: complication of a Klebsiella liver abscess.Among the various causative agents of an abscess of the liver, Klebsiella is a frequent and well-known cause, and its imaging findings have been described in the past decades. We report two cases of this type of abscess, which were of interest because of associated findings indicating a subhepatic thrombophlebitis of the liver, a process which could have explained the development of a concomitant pulmonary infectious process.- - - - - - - - - - ranking = 0.46153846153846keywords = abscess (Clic here for more details about this article) |
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