PYOGENIC HEPATIC-ABSCESS - A 10-YEAR POPULATION-BASED RETROSPECTIVE STUDY

A 10-year retrospective survey was undertaken of patients with pyogeni c hepatic abscesses (PHA). Fifty-two patients fulfilled the criteria o f PHA, equivalent to a mean annual incidence of 11/1,000,000. The main symptom was fever. Laboratory tests were compatible with infection, s lightly elevated alkaline phosphatase being the only test pointing tow ards the liver as the focus of infection. Forty-one patients (79%, 95% CL, 68-90%) had positive cultures from aspirated pus, with a total of 79 isolates. Enteric Gram-negative rods accounted for 45% and anaerob ic bacteria for 31% of PHA isolates. Gram-positive cocci, predominantl y non-haemolytic streptococci, were the third largest group (19%), but were rare among blood isolates. Positive blood cultures were found in 21 patients (40%, 95% CL, 27-54%), with a total of 28 isolates. Percu taneous drainage was performed in 26, percutaneous needle aspiration i n 10, combinations thereof in 5, and abdominal surgery in 5. Forty-nin e patients received systemic antibiotic therapy, four of whom were tre ated with antibiotics only. Seven recurrences occurred and the overall case fatality rate was 6% (95%, CL 0-12%), which might reflect a low rate of underlying malignant diseases in our study material.