Study of clinico-aetiological profile and management of liver abscess in a tertiary care centre

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Background: Liver abscess if diagnosed late or left untreated, the disease leads to fatal course with significant morbidity and mortality. Methods: We prospectively studied the clinical presentations, aetiological factors, microbiological aetiology, management and outcome in 30 patients with liver abscess seen over a period of 6 months at our tertiary care hospital. Results: Their mean age was 50.1 (range 18 to 84) years; there were 24 (80%) males. The common symptoms were fever (80%), abdominal pain (20%) and vomiting and jaundice (10%). The common laboratory abnormalities were increased alkaline phosphatase (80%), leucocytosis (65%), hyper-bilirubinaemia (45%) and hypoalbuminaemia (70%). Abdominal ultrasonography was diagnostic in 90% of cases. Fifteen (50%) patients had positive microbial culture reports. The most common organism identified was Escherichia coli (40%) followed by Entamoeba (15%); Pseudomonas (10%); Klebsiella and Enterococcus (5%) and Mycobacterium tuberculosis in one patient. Percutaneous needle aspiration and drainage were employed as the primary therapy in 24 patients. Biliary disease accounted for 18 cases and 6 were considered to be idiopathic. Four patients (13%) died. Conclusions: Liver abscess is a diagnostically challenging problem due to nonspecific presenting characteristics. Our observations emphasise the importance of percutaneous drainage as a mainstay of therapy.