[Pyogenic liver abscesses of cryptogenic origin].

OBJECTIVE

To analyze and clarify the clinical behaviour and outcome of patients with pyogenic liver abscess of cryptogenic origin and, moreover, to observe if there are any differential characteristics in relation to those found in patients with a known pathogenesis.

MATERIAL AND METHODS

Multicenter and retrospective study of two groups of patients diagnosed of pyogenic liver abscess, during a period of 13 years. Group 1: 34 cases with abscess of cryptogenic origin and Group 2: 99 patients with a known pathogenesis. Clinical, laboratory, and microbiologic data, morphology and topography of the lesions, treatment and outcome were assessed and compared in both groups.

RESULTS

The duration of symptomatology was higher in Group 1 (9.4 +/- 6.5 vs 8.1 +/- 4.4 days; p = 0.05). Although, in this category of patients, it was also observed a lower frequency of jaundice (6 vs 26%; p = 0.02) and lower level of bilirubinemia (0.9 +/- 0.9 vs 2.6 +/- 4.4 mg/dl; p = 0.05), the majority of clinical and laboratory data were similar in both groups. The rate of patients with abscesses on the left lobe (26% vs 12%; p = 0.04) was higher in Group 1. The therapeutic modality carried out in the two groups was not significantly different, neither were hospital stay, and morbidity and mortality rates.

CONCLUSIONS

The patients with pyogenic liver abscesses of cryptogenic origin present few specific clinical characteristics which facilitate the diagnosis. Besides, their outcome was no significantly different from that found in patients with abscesses of known pathogenesis.