Liver abscess in Prapokklao Hospital.

Abstract

Background : Liver abscess is a common problem in Thailand. In pre-antibiotic era, half of cases were amoebic liver abscess (ALA). However, presently, many studies found that bacteria are more likely to account for liver abscess than Entamoeba histolytica.

Objectives : 1) To examine the incident rate, causatic organisms, symptoms/signs, associated diseases, duration of hospital stay and common complication in relation to liver abscess.
2) To suggest the proper management for patients with liver abscess.

Methodology : We reviewed all cases of liver abscess diagnosed by liver aspiration at Prapokklao hospital from Januray 2003 to December 2007. Data were retrieved from hospital records of admitted patients. Descriptive statistics used included mean and standard derviation. Analytical statistic employed was Wilcoxon - Mann Whitney test.

Results : There were 25 patients who were diagnosed with liver abscess. Of these,28 percent and 72 percent were ALA and pyogenic liver abscess (PLA)respectively. Gram negative bacteria were the predominated pathogens causing PLA (Klebsiella pneumoniae 20 percent , Burkholderia pseudomallei 20 percent, Escherichia coli 2 percent). The common clinical symptoms and blood chemistry were not different between 2 groups except total white blood count that was higher in PLA. Yet, the duration of hospital stay was longer among patients with PLA.

Conclusions : Currently, in Prapokklao hospital, most of liver abscess cases are attributed to gram negative bacteria.The most common pathogens are Klebsiella pneumoniae and Burkholderia pseudomallei.