Morbidity and mortality in children with pyogenic liver abscess
V. M. Pineiro-Carrero and J. M. Andres
Department of Pediatrics, Wilford Hall Medical Center, Lackland Air Force Base, Texas.
Review of our experience from 1975 to 1986 and a literature survey
disclosed 109 children with pyogenic liver abscess. During this time, newer
imaging techniques, especially ultrasonography and computed tomography,
facilitated the prompt diagnosis of cystic lesions within the liver
parenchyma. The incidence of pyogenic liver abscess at our institution (25
per 100,000 pediatric hospital admissions) was higher than previously
reported. Since the majority of abscesses were located in the right lobe of
the liver, patients were most effectively treated with percutaneous
drainage of the abscess cavity. Staphylococcus aureus was the most common
bacterial agent responsible for pyogenic liver abscess; however, anaerobic
organisms were noted as a major group of pathogens and represented 27% of
our patients. Furthermore, one patient was discovered to have multiple
microabscesses of the liver associated with cat-scratch disease;
pleomorphic gram-negative bacilli were not cultured. Among the 109
patients, the overall mortality of 15% was considerably better than that
for children with PLA before 1975. The improved survival may be related to
more prompt diagnosis of pyogenic liver abscess followed by evacuation of
the liver abscess and antibiotic therapy.
