Clinicopathological presentation of liver abscesses and hydatid liver disease from two South African tertiary hospitals  

作　　者：Krevosha Pillay Zafar Ahmed Khan Ekene Emmanuel Nweke Jones Omoshoro-Jones 

机构地区：[1]Department of Surgery,University of Witwatersrand,School of Clinical Medicine,Johannesburg 2193,Gauteng,South Africa [2]Department of Hepatobiliary Surgery,Chris Hani Baragwanath Academic Hospital,Soweto 1864,Gauteng,South Africa

出　　处：《World Journal of Hepatology》2024年第12期1417-1428,共12页世界肝病学杂志（英文）

摘　　要：BACKGROUND Hepatic abscesses represent infections of the liver parenchyma from bacteria,fungi,and parasitic organisms.Trends in both abscess microbiology and manage-ment of abscesses(infective collections)have changed over the past decade.There is a paucity of published data regarding the clinicopathological features of liver abscesses in sub-Saharan Africa and other low-income and middle-income coun-tries.AIM To evaluate the clinical presentations of liver abscesses and hydatid liver disease at two South African tertiary-level hospitals.METHODS Information accessed from electronic discharge summaries of patients from two South African referral hospitals in Johannesburg,South Africa from January 2016 to December 2020 were reviewed and analyzed.All patients older than 13 years presenting with infective liver collections(pyogenic,amoebic)and hydatid di-sease were included.Clinical findings and laboratory,microbiology,and radio-logy results and outcomes were collated and analyzed.RESULTS In total,222 patients were included.There were 123 males(55.41%)and 99 females(44.59%),with a median age of 48 years.Comorbidities included HIV(24.23%),hypertension(20.57%),and diabetes mellitus(16.83%).The majority(74.77%)of abscesses were pyogenic,while amoebic and hydatid abscesses represented 16.22%and 9.01%,respectively.The predominant etiology of the pyogenic liver abscesses(PLA)was biliary-related disease.WBC and C-reactive protein were significantly higher in the pyogenic group(P<0.0002 and P<0.007,respectively)when compared to the amoebic and hydatid groups.In patients with PLAs,organisms were cultured on blood in 17.58%and abscess fluid in 56.60%.Klebsiella,Escherichia coli and Streptococci were the most cultured organisms.Sixteen percent of the cultures were polymicrobial.In the overall group,76.00%(n=169)of patients requiring drainage had a percutaneous transhepatic catheter drain placed,while 8.76%(n=19)had open surgery.The median length of hospital stay was 13 days.The mortality rate was 3.02%.CONCLUSION In this study,

关 键 词：Amoebic liver abscess Hydatid liver disease Liver Echinococcosis Human Immunodeficiency Virus Pyogenic liver abscess Percutaneous drainage 

分 类 号：R563.1[医药卫生—呼吸系统] R575[医药卫生—内科学]