Liver Abscess in Children

Milford, Karen; Gaxa, Luvo; S, Cox; Tasker, D. G. C.; Banderker, Ebrahim

doi:10.1055/s-0037-1600114

Cited by 4 publications

(1 citation statement)

References 33 publications

(147 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Underlying disease and predisposing host factors that have been proposed to be associated with the development of liver abscess include immunocompromised status (malignancy, malnutrition, and chemotherapy or immunosuppressant user), chronic granulomatous disease, sickle cell disease, diabetes mellitus, biliary tract anomalies, abdominal trauma, certain parasitic infections, systemic sepsis, perforated appendicitis, umbilical infection, and incorrect umbilical venous catheterization (2,10,15,16,(19)(20)(21)(22). Nevertheless, the majority of pyogenic liver abscesses are cryptogenic (2,23). Cryptogenic liver abscess accounted for 47.4% (18/38) of cases in our study, which was a comparatively lower proportion to prior Taiwanese reports among children (53-80%) (8)(9)(10).…”

Section: Discussioncontrasting

confidence: 63%

Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center

et al. 2020

View full text Add to dashboard Cite

Background: Liver abscess is an important but relatively rare disease in children. This study investigated the clinical characteristics of eligible patients at a referral tertiary center over the past two decades. Method: A 20-year retrospective study (January 2000-December 2019) enrolled 38 children diagnosed with liver abscess. Demographic data; clinical features; laboratory, imaging, and microbiological findings; management strategy; and outcomes were reviewed from the patients' medical records. Results: Thirty-eight cases of pyogenic liver abscess were identified without a culture-proven amebic or fungal abscess. The mean age of diagnosis was 9.6 ± 6.2 years, and the male-to-female ratio was 1.92: 1. Hemato-oncological (28.9%) and predisposing hepatobiliary diseases (23.7%) were the two most common predisposing factors. Fever (94.7%) was the most common presentation followed by right upper quadrant abdominal pain (42.1%) and pleural effusion (34.2%). Among the laboratory parameters, leukocytosis was common (70.3%), and all patients had elevated serum C-reactive protein levels. Increased serum levels of alanine aminotransferase, aspartate aminotransferase, direct bilirubin, and total bilirubin were found in 40.5, 48.6, 23.1, and 42.9% of the cases, respectively. The most common pathogen in blood and pus cultures was Klebsiella pneumoniae. The mean durations of intravenous antibiotic and total antibiotic use were 29.0 ± 15.7 and 45.1 ± 22.1 days, respectively. Twelve patients (31.6%) were treated with antibiotics alone, while percutaneous needle aspiration, percutaneous pigtail drainage, and surgical intervention were performed in 12 (31.6%), 10 (26.3%), and 5 (13.2%) patients, respectively. No mortality was documented in this series. Conclusion: The present study reflects a relatively declining incidence of liver abscess compared with prior studies in Taiwan. K. pneumoniae remains the most prevalent pathogen in both blood and abscess cultures in Taiwan. Proper antimicrobial therapy with timely drainage generally yielded an adequate treatment response without any mortality.

show abstract

Section: Discussioncontrasting

confidence: 63%

Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center

et al. 2020

View full text Add to dashboard Cite

show abstract

Liver Abscess in Children-experience From a Single Tertiary Care Center of North India

Lal¹,

Venkatesh²,

Kumar³

et al. 2021

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background: Liver abscess (LA), a common problem in children in the tropics, is believed to be mostly pyogenic (PLA), sometimes amebic (ALA). We aimed to analyze the clinical profile, etiology, risk factors for complications, management and outcomes of LA in children. Methods:The details of 81 children with LA managed in a tertiary set up over a period of 3 years were analyzed. A comparison of different parameters was performed with respect to etiology and complications. Results: ALA, PLA and mixed infection LA were diagnosed in 40 (49.4%), 32 (39.5%) and 9 (11.1%) children. The triad of fever, hepatomegaly and right upper quadrant tenderness was seen in 65 (80.2%). Coagulopathy was observed in 60 (77%) and jaundice in 12 (14.8%). Majority (71.6%) had a single LA in the right lobe (69%). Conservative, percutaneous needle aspiration, percutaneous catheter drainage and surgical drainage were done in 11.1%, 3.7%, 82.7% and 2.5%, respectively. Forty-three (53.1%) had complicated LA with rupture in 55.8% and vascular thrombosis in 16.2%. Children with complicated LA had higher alanine transaminase, prolonged prothrombin time/international normalized ratio, low serum protein and albumin levels (P < 0.05). Median duration of follow-up was 2 months and mean time to resolution of LA was 48.5 ± 18 days. Conclusions: ALA is the commonest cause of pediatric LA in endemic regions and is difficult to differentiate from PLA clinically. Percutaneous catheter drainage is safe and effective modality for the management of LA in children. A higher alanine transaminase, prolonged prothrombin time/ international normalized ratio and low serum albumin levels (<3 g/dL) at presentation identify complicated LA.

show abstract

Fever and Abdominal Pain in a 13-Year-Old Boy

Azevedo

Miranda

Silva

et al. 2023

Clin Pediatr (Phila)

View full text Add to dashboard Cite

A previously healthy 13-year-old boy, 2 weeks prior to the presentation, developed diarrhea (3 watery stools per day non-mucoid/bloody), vomiting, and fever, was diagnosed with acute gastroenteritis and prescribed with probiotics. These symptoms resolved, but after 1 week fever recurred. Moreover, patient developed abdominal pain, located to the right upper quadrant, radiation to the right iliac fossa, variable intensity, and no specific relation to food intake. Pain in the right shoulder was also mentioned. The patient continued to worsen clinically with progressive anorexia, lethargy, and 5 kg weight loss which prompted presentation to the pediatric emergency department. He had no respiratory and urinary symptoms. There was no recent travel history or animal exposure. The patient denied either consumption of undercooked food or unbottled water.On physical examination, he was markedly pale. His abdomen was soft with diffuse mild tenderness, more significant on the right quadrants. There was no rebound tenderness located at the McBurney point. No organomegalies were found. The remaining physical examination was normal.Initial laboratory test results revealed the following: hemoglobin level, 11.2 g/dL; white blood cell count, 27.14 × 10 9 /L (77% neutrophils, 10% lymphocytes); platelet count, 425 × 10 9 /L; C-reactive protein level was 22.19 mg/dL; hepatic enzymes levels were high: aspartate aminotransferase, 94 U/L and alanine aminotransferase, 130 U/L. Gamma-glutamyl transferase level was 161 U/L, alkaline phosphatase level was 324 U/L, and lactate dehydrogenase level was 569 U/L. Coagulation tests were unremarkable. Blood and urine cultures were performed.A chest radiograph showed a small right-sided pleural effusion. Abdominal ultrasound demonstrated a

show abstract

Liver Abscess in Children

Cited by 4 publications

References 33 publications

Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center

Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center

Liver Abscess in Children-experience From a Single Tertiary Care Center of North India

Fever and Abdominal Pain in a 13-Year-Old Boy

Contact Info

Product

Resources

About