| Popis: |
Objective: To describe clinical features and laboratory characteristics, treatment outcomes of liver abscess treated at Institute of Clinical Infectious Diseases. Subject and method: This is a retrospective descriptive study on 65 patients with liver abscess, treated at the Institute of Clinical Infectious Diseases - 108 Military Central Hospital, from January 2018 to June 2022. Result: The majority of patients were male (85%), from 41 to 70 years of age, had diabetes (44.62%). Clinical symptoms were prolonged fever: (92.31%); chills (75.38%), right upper quadrant pain (83.08%), jaundice (21.54%). Inflammatory marker: leukocytosis 75.4%; elevated procalcitonin (68.75% PCT > 10ng/ml). Liver function test: Elevated liver enzyme 83.1%, increased bilirubin 52.3%, prolong prothrombin time 47.7%; decreased albumin (63.1%) and thrombocytopenia 21%. About 94% liver abscess were single foci, located in the right liver lobe (81.54%), large size > 5cm accounted for 75.35% with mixed features on ultrasound (84.62%). Among 41 strains of bacteria isolated, Klebsiella pneumoniae (87.8%); E. coli (9.75%) and Streptococcus sp. (2.45%). Mortality rate: 1.54%. In total: 83.07% patients underwent invasive procedure (Aspiration: 50.77% and Percutaneous drainages: 32.3%). Mean duration in hospital (days): 14.77 ± 6.37 with mean deferverescent time was: 4.45 ± 2.36 (days). Conclusion: The clinical features of LA still remain typical with prolonged fever, chills and right upper quadrant pain. Patients with an advanced ages and diabetes mellitus as an underly condition appear LA. The sub-clinical characteristic were an increased inflammatory marker and abnormal liver function tests. On ultrasound, majority of patients had one abscesses > 5cm on the right liver lobe. Treatment with broad spectrum antibiotics and minimal invasive procedures including aspiration and percutaneous drainage showed good response. |
