Pyogenic Liver Abscess: A Tertiary Center Experience in Latvia

Plūme P1,2*, Tauvēna E1, Grēve M3, Vilmanis J1,2, Liepiņa AE4, Ozoliņš A1,2 and Gardovskis J1,2

1Department of General Surgery, Pauls Stradiņš Clinical University Hospital, Latvia
2Department of surgery, Riga Stradiņš University, Latvia
3Statistics Unit, Riga Stradiņš University, Latvia
4Riga Stradiņš University, Riga, Latvia

^*Correspondance to: Pāvils Plūme 

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Abstract:

Background and Objectives: A liver abscess is a serious and potentially life-threatening medical condition characterized by the formation of a pus-filled cavity within the liver tissue. Pyogenic Liver Abscesses (PLA) are primarily monomicrobial, with specific pathogens emerging as predominant agents in most cases. This study was conducted to analyze the epidemiological parameters, diagnostic factors and management strategies employed as well as outcomes in patients presenting with PLA. Materials and Methods: A retrospective cross-sectional study of patients treated for PLA at Hepatopancreatobiliary (HPB) surgery unit of Pauls Stradiņš Clinical University Hospital - a tertiary teaching center was conducted with a total of 98 patients included in the study. The patient data were retrieved and reviewed after permission of ethics commission. Time period of the study was set for six years and involved data from patients treated at our institution between January 2018 and December 2023. Results: In this study of 98 patients with PLA, cultures were positive in 68.4% of cases, and 16.3% had positive blood cultures indicating septicemia. Klebsiella pneumoniae (42.9%) and Escherichia coli (11.2%) were the most common pathogens isolated. Polymicrobial flora was found in 17.6% of cases, while 31.6% had no isolated pathogens. Percutaneous drainage or needle aspiration was performed in 85.7% of patients, with surgical management needed in 6.1% due to failed percutaneous drainage and in 8.2% due to abscess location or characteristics. Factors like biliary tract disease, positive antimicrobial resistance, multifocal abscesses, and surgical management – affected hospitalization time. Conclusion: Multiple factors, including existing biliary disease, antimicrobial resistance (particularly ESBL), abscess size and location, and management strategies, impact the hospital stay of patients with PLA.

Keywords:

Pyogenic; Liver abscess; Percutaneous drainage; Klebsiella

Cite the Article:

Plūme P, Tauvēna E, Grēve M, Vilmanis J, Liepiņa AE, Ozoliņš A, et al. Pyogenic Liver Abscess: A Tertiary Center Experience in Latvia. Ann Clin Case Rep. 2024; 9: 2685..