Liver abscess in the tropics: an experience from Nepal.

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dc.contributor.authorKarki, Prahladen_US
dc.contributor.authorAnsari, J Aen_US
dc.contributor.authorKoirala, Sen_US
dc.date.accessioned2009-05-27T15:23:22Z
dc.date.available2009-05-27T15:23:22Z
dc.date.issued2004-06-05en_US
dc.descriptionThe Southeast Asian Journal of Tropical Medicine and Public Health.en_US
dc.description.abstractThirty-six consecutive cases of liver abscess seen at the BP Koirala Institute of Health Sciences Hospital, Dharan, Nepal, from 1995 to 1998, were reviewed. Twenty-one cases were male and 15 female, with a mean age of 42 years. Twenty-four cases (66.7%) were amebic, 7 (19.4%) pyogenic, 3 (8.3%) indeterminate and 2 (5.5%) tuberculous. The most frequent clinical features included fever (88%), leukocytosis (66.7%), abnormal level of serum albumin (44.4%) and alkaline phosphatase (38.9%). The liver abscess was single in 61.1%, multiple in 27.8%, and in 66.7% of cases the abscess was present in the right lobe of the liver. Ultrasonography was diagnostic in all cases. A positive culture of the abscess was obtained in 7 cases (19.4%). The most frequent bacteria found were Klebsiella pneumoniae (4;11.1%), followed by Escherichia coli (3;8.3%). Two cases were due to Mycobacterium tuberculosis and none had malignancy. Percutaneous drainage was performed in 27 patients (75%). Mortality attributable to the abscess was 5.5%. We found percutaneous needle aspiration of liver abscess helpful in confirming diagnosis, as it provides a better bacteriological culture yield, gives a good outcome, and may uncover clinically unsuspected conditions like malignancy and tuberculosis. These two conditions should certainly be considered possible causes in our part of the world when an abscess fails to respond to standard treatment. In developing countries like Nepal, the clinical presentation of liver abscess has not varied over time. At present, rapid diagnosis and image-guided percutaneous drainage offer a better prognosis for liver abscess. We also recommend routine cytological examination of aspirated abscess materials, as well as stains and cultures for acid-fast bacilli.en_US
dc.description.affiliationDepartment of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal. prahladkarki@hotmail.comen_US
dc.identifier.citationKarki P, Ansari JA, Koirala S. Liver abscess in the tropics: an experience from Nepal. The Southeast Asian Journal of Tropical Medicine and Public Health. 2004 Jun; 35(2): 425-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/32663
dc.language.isoengen_US
dc.source.urihttps://www.tm.mahidol.ac.th/seameo/2004_35_2/31-3211.pdfen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshBiopsy, Needleen_US
dc.subject.meshEscherichia coli --isolation & purificationen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshKlebsiella pneumoniae --isolation & purificationen_US
dc.subject.meshLiver Abscess --classificationen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMycobacterium tuberculosis --isolation & purificationen_US
dc.subject.meshNepal --epidemiologyen_US
dc.subject.meshTropical Climateen_US
dc.titleLiver abscess in the tropics: an experience from Nepal.en_US
dc.typeJournal Articleen_US
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