Abscesos hep芍ticos: an芍lisis retrospectivo de 68 casos

作者：Eroles Vega; G; Mecina Gutierrez; A B; Fernandez Garcia; C; Mancebo Plaza; A B; Riva Jimenez; I de la

来源：Anales de Medicina Interna, 2008.

DOI：10.4321/S0212-71992008000700005

• pyogenic liver abscess
• microbiology
• diagnosis
• therapy
• percutaneous drainage
• prognosis
• mortality.

objetive: to assess clinical and laboratory features of patients with liver abscesses (la), and determine prognostic features. methods: we performed a retrospective analysis of medical records of patients receiving a diagnosis of la in the hospital severo ochoa, between 1989-2005. results: we were able to find 68 patients: 39 males and 29 females; the incidence amounts 26 cases/100,000 hospital admissions; mean age 63 years. a biliary source accounted for 37%, 16% were of portal origin, 7% were ascribed to hematogenous dissemination, 4% direct inoculation during a procedure and no cause could be found in 35%. liver ultrasonography allowed diagnosis in 43% of cases, and ct scan un 57%. sixty-two percent of la were larger than 3 cm in diameter; 28% of cases had multiple abscesses. cultures of abscess fluid were positive in 71%, and blood cultures in 52%. globally, we were able to isolate the causal microorganism in 73.5% of cases. hundred percent of patients received antimicrobials, 56% had percutaneous drainage performed and 25% were surgically managed. there were complications in 13%, 9% suffered recurrences and we found a 19% mortality rate. conclusions: la has an ill-defined clinical picture. a history of neurological disease or abdominal tumor, and multiple la are associated with an increased complication rate. following factors correlated with increased mortality: age-adjusted charlson%26apos;s morbidity index ≡5; quick index %26lt; 60% and development of complications. drainage indication has to be individualized.