Pyogenic liver abscess

Mazza, Oscar; Santibañes, Martín de; Santibañés, Eduardo de

doi:10.1016/b978-0-323-34062-5.00072-8

Cited by 1 publication

(12 citation statements)

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“…Escherichia coli was the most common bacteria cultured (18/42); this is similar to findings in both cats and people with hepatic abscesses 19,24 . Only 5 of 42 dogs had polymicrobial infections, which represents a divergence from cats and people, in which the majority of infections have been characterized as polymicrobial 24,25 .…”

Section: Discussionsupporting

confidence: 69%

“…Only 37 of 48 dogs had abscesses identified on ultrasound in this study; those without detectable abscesses may have had microabscessation or abscessation in areas of the liver that are difficult to visualize. In people, ultrasonography remains the most common initial diagnostic imaging modality because it is a fast, inexpensive, and reliable method for imaging the biliary tree, which is the most common source of hepatic infections 19 . However, ultrasonographic sensitivity for hepatic abscessation is 85% in people, as compared to CT, which has a 97% sensitivity 20–22 .…”

Section: Discussionmentioning

confidence: 99%

“…Multifocal liver abscessation most commonly has a biliary origin, which is also the most common etiology of hepatic abscessation in people, while single lesions tend to be cryptogenic in origin 23 . Multifocal microabscessation (<2 cm diameter) is frequently associated with coliform/enteric organisms or hematogenous spread 19 . The distribution of etiologies of hepatic abscessation in dogs in the current study is unknown as these data were not recorded for most patients, so it is difficult to compare to the human literature.…”

Section: Discussionmentioning

confidence: 99%

“…Only 5 of 42 dogs had polymicrobial infections, which represents a divergence from cats and people, in which the majority of infections have been characterized as polymicrobial 24,25 . This may be reflective of different etiologies, as abscesses secondary to hematogenous spread are more likely to be monomicrobial caused by staphylococci and streptococci, while those secondary to biliary tract disease or a GI source tend to be polymicrobial with a predominance of gram‐negative organisms and anaerobes 19 . In the current study, the decision to submit aerobic and anaerobic cultures was at the discretion of the attending clinician, and not all dogs had anaerobic cultures performed.…”

Section: Discussionmentioning

confidence: 99%

“…In people, surgical debridement of hepatic abscesses is no longer considered standard of care, and percutaneous needle aspiration and catheter drainage are now standard first‐line methods for treatment of both solitary and multifocal hepatic abscesses. Surgery is typically reserved for patients in whom less invasive methods have failed, septic peritonitis is suspected, or surgery is required to treat the underlying cause of the abscess 19 . Additionally, some patients can be managed with antibiotics alone when abscesses are relatively small (<5 cm in diameter) 25 .…”

Section: Discussionmentioning

confidence: 99%

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Hepatic abscessation in dogs: A multicenter study of 56 cases (2010–2019)

Burke,

Hess,

McEntee

et al. 2023

J Vet Emergen Crit Care

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ObjectiveTo investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation.DesignRetrospective cohort study from 2010 to 2019.SettingMulticenter study.AnimalsFifty‐six client‐owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology.Measurements and Main ResultsDogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56). Abnormal physical examination findings included increased temperature (41/56) and abdominal pain (22/54). CBCs revealed neutrophilia (31/49), toxic changes (25/49), anemia (28/49), and thrombocytopenia (23/49). Biochemical analyses revealed increased alkaline phosphatase (45/50), increased alanine aminotransferase (40/50), hypoalbuminemia (25/48), and hyperbilirubinemia (19/49). Hypoglycemia was found in 13 of 49 dogs. Hepatic abscesses ranging from 0.5 to 15 cm in diameter were identified ultrasonographically in 37 of 48 dogs; 19 of 37 had solitary abscesses, and 18 of 37 had multifocal abscessation. Escherichia coli was the most commonly cultured organism, isolated in 18 of 42 cases. Histopathology revealed underlying hepatic neoplasia in 10 of 47 dogs. Surgical management was performed in 41 of 49 dogs, and 35 of 41 survived to discharge. Medical management was performed in 8 of 49 dogs, and 5 of 8 survived to discharge. With univariate analysis, hypoglycemia and multifocal abscessation were associated with decreased odds of survival (odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.03–0.9, P = 0.04; OR: 0.07, 95% CI: 0.01–0.6, P = 0.02, respectively). With multivariate analysis, only multifocal abscessation was associated with decreased odds of survival (OR: 0.09, 95% CI: 0.01–0.87, P = 0.04).ConclusionsHepatic abscessation, although rare, should remain a differential diagnosis for dogs presenting with nonspecific clinical signs and increase liver enzyme activities, especially with concurrent increased temperature and neutrophilia. Rate of survival to discharge for dogs in this study was consistent with previously reported survival rates, with 40 of 56 (71%) of the total population surviving to discharge. No variables assessed were able to predict survival to discharge; however, hypoglycemia and multifocal abscessation should be assessed in larger populations to determine prognostic significance.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%