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Clinical, laboratory, and management profile in patients of liver abscess from northern India.

ABSTRACT: Objective. To describe the clinical profile, microbiological aetiologies, and management outcomes in patients with liver abscess. Methods. A cross-sectional study was conducted from May, 2011, to April, 2013, on 200 consecutive liver abscess patients at PGIMER and Dr. RML Hospital, New Delhi. History, examination, and laboratory investigations were recorded. Ultrasound guided aspiration was done and samples were investigated. Chi-square test and multivariate regression analysis were performed to test association. Results. The mean age of patients was 41.13 years. Majority of them were from lower socioeconomic class (67.5%) and alcoholic (72%). The abscesses were predominantly in right lobe (71%) and solitary (65%). Etiology of abscess was 69% amoebic, 18% pyogenic, 7.5% tubercular, 4% mixed, and 1.5% fungal. Percutaneous needle aspiration was done in 79%, pigtail drainage in 17%, and surgical intervention for rupture in 4% patients. Mortality was 2.5%, all reported in surgical group. Solitary abscesses were amoebic and tubercular whereas multiple abscesses were pyogenic (P = 0.001). Right lobe was predominantly involved in amoebic and pyogenic abscesses while in tubercular abscesses left lobe involvement was predominant (P = 0.001). Conclusions. The commonest presentation was young male, alcoholic of low socioeconomic class having right lobe solitary amoebic liver abscess. Appropriate use of minimally invasive drainage techniques reduces mortality.

SUBMITTER: Ghosh S

PROVIDER: S-EPMC4066852 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Clinical, laboratory, and management profile in patients of liver abscess from northern India.

Ghosh Soumik S Sharma Sourabh S Gadpayle A K AK Gupta H K HK Mahajan R K RK Sahoo R R Kumar Naveen N

Journal of tropical medicine 20140604

Objective. To describe the clinical profile, microbiological aetiologies, and management outcomes in patients with liver abscess. Methods. A cross-sectional study was conducted from May, 2011, to April, 2013, on 200 consecutive liver abscess patients at PGIMER and Dr. RML Hospital, New Delhi. History, examination, and laboratory investigations were recorded. Ultrasound guided aspiration was done and samples were investigated. Chi-square test and multivariate regression analysis were performed to ...[more]

PMID: 25002869

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Project description:BackgroundAmebic liver abscess (ALA) is endemic in Bangladesh since historical age but its epidemiology and sociodemographic determinants are not well described in the literatures. This paper focuses on the endemicity, sociodemographic determinants and clinical outcomes of ALA patients from certain northern districts in Bangladesh. Ninety hospitalized ALA patients enrolled from 6 northern districts of Bangladesh during July 2008 to June 2010 were analyzed.FindingsClinical presentations of ALA was initially substantiated by ultrasound imaging and later confirmed by detection of small subunit rRNA gene of E. histolytica using a Real Time PCR. Structured questionnaire and data sheet were used to record sociodemographic characteristics, clinical presentations and outcomes. Patients were followed for immediate and late treatment outcomes up to 2 years since diagnosis. Northern districts those situated on the Ganges basin were noted as endemic areas. Male significantly outnumbered the female with a male to female ratio of 21:1 and majority of patients (58%) were in their 3rd and 4th decades. A significant (21%) number of patients were aborigines despite their ethnic minority as population under investigation and overall 68% belonged to low socioeconomic group. Habit of indigenous alcohol consumption was very high (78%) among ALA patients with overwhelming majority was illiterate (74.44%) and from rural population (70%). Fever with right hypochondriac pain of variable duration was the principal presenting complains. Gross fluid derangements including pleural effusion, edema and ascities were observed in 39% cases and 6% had rupture of abscess. All patients were treated with standard antimicrobial regimen and discharged with initial recovery. Recurrent attack was observed in 6% cases and 3 (3.33%) patients died during 2 years follow-up period. Complicated (37.78%) ALA patients showed significant Odds ratio (P < 0.05) for major sociodemographic determinants in comparison to non-complicated patients.ConclusionsAmebic liver abscess is endemic in certain northern districts of Bangladesh especially on the Ganges basin with relatively high prevalence among aborigines. Rural habitat, ethnicity (Aborigine) and habit of indigenous alcohol consumption were found to be strong determinants, especially for complicated ALA, which were associated with different grades of morbidity and a few mortalities.

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Clinical, laboratory, and management profile in patients of liver abscess from northern India.

Publications

Clinical, laboratory, and management profile in patients of liver abscess from northern India.

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