Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- 42 Acute Viral Hepatitis
- 43 Chronic Hepatitis
- 44 Biliary Infection: Cholecystitis and Cholangitis
- 45 Pyogenic Liver Abscess
- 46 Infectious Complications of Acute Pancreatitis
- 47 Esophageal Infections
- 48 Gastroenteritis
- 49 Food Poisoning
- 50 Antibiotic-Associated Diarrhea
- 51 Sexually Transmitted Enteric Infections
- 52 Acute Appendicitis
- 53 Diverticulitis
- 54 Abdominal Abscess
- 55 Splenic Abscess
- 56 Peritonitis
- 57 Whipple's Disease and Sprue
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
45 - Pyogenic Liver Abscess
from Part VII - Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- 42 Acute Viral Hepatitis
- 43 Chronic Hepatitis
- 44 Biliary Infection: Cholecystitis and Cholangitis
- 45 Pyogenic Liver Abscess
- 46 Infectious Complications of Acute Pancreatitis
- 47 Esophageal Infections
- 48 Gastroenteritis
- 49 Food Poisoning
- 50 Antibiotic-Associated Diarrhea
- 51 Sexually Transmitted Enteric Infections
- 52 Acute Appendicitis
- 53 Diverticulitis
- 54 Abdominal Abscess
- 55 Splenic Abscess
- 56 Peritonitis
- 57 Whipple's Disease and Sprue
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
First described by Hippocrates, pyogenic liver abscess is an uncommon but important hepatic infection. The relative infrequency of abscess formation, despite the extensive exposure of the liver to bacteria from its dual blood supply, is related to the efficiency of the Kupffer cells in filtering bacteria. Over the past several decades with easily accessible imaging techniques enabling prompt diagnosis, potent antibiotics and effective drainage procedures, the mortality from pyogenic liver abscess has declined dramatically.
EPIDEMIOLOGY
In the first large published series of cases of pyogenic liver abscess in the United States, based on patients at Charity Hospital in New Orleans, there was an incidence of 8 cases per 100 000 admissions. There was a 2:1 male predominance with a mortality rate of 72%. Several studies published around 40 years later show significant demographic changes. In the initial report most patients were in their 3rd decade of life compared to the 5th to 6th decades in later series. Although the incidence of abscesses appears to be increasing by a factor of 2, the male predominance has disappeared and the mortality rate has fallen to approximately 12%. These differences probably reflect changes in the underlying factors causing the abscesses. Most of the earlier cases likely resulted from intra-abdominal infections such as diverticulitis or appendicitis. With better diagnostic imaging techniques, along with the availability of potent antibiotics, complications from abscess formation after intra-abdominal infections has diminished significantly.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 327 - 330Publisher: Cambridge University PressPrint publication year: 2008