PMID: 3752893Apr 1, 1986Paper

Liver abscess--a clinical study

Annals of the Academy of Medicine, Singapore
L B TehC S Seah

Abstract

Forty consecutive cases of liver abscess from the Department of Medicine III, Singapore General Hospital, from 1978 to July 1983 were reviewed. Nineteen (47.5%) were amoebic, 15 (37.5%) pyogenic and 6 (15%) of unknown aetiology. Of the first 20 cases from 1978 to 1980, amoebic abscesses (60%) predominated. An increased incidence of pyogenic abscess constituting 50% was seen in the next 20 cases. Though all racial groups were affected, a predilection among Indians was seen. Males outnumbered females (4:1), and peak incidence occurred in the 40 to 70 age group (62.5%). Fifty percent presented early (less than one week of symptoms) to hospital. Common physical signs were fever (97.5%) and hepatomegaly (92.5%). Investigations showed leucocytosis in excess of 10,000 WBCs/cmm (87.5%), an ESR of 80 mm/hr (80%) and an elevated alkaline phosphatase of at least twice normal (73.6%). Single abscesses (72.5%) located in the right lobe were more likely to be amoebic. Where abscesses were multiple, they were more likely to be pyogenic (63.6%). Two-thirds of the pyogenic abscesses were due to either Klebsiella species or E. coli. Medical treatment consisted of broad spectrum antibiotics, usually in combination with metronidazole. Aspiration o...Continue Reading

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