Tsai Chia-Chang, Chung Jiin-Haur, Ko Sheung-Fat, Liu Po-Mai, Su Chin-Tien, Li Wen-Chieh, Liang Chi-Di, Huang Li-Tung, Huang Chung-Bin, Tiao Mao-Meng
Department of Pediatrics, Chang Gung University, Chang Gung Children's Hospital, Kaohsiung, Taiwan.
Acta Paediatr Taiwan. 2003 Sep-Oct;44(5):282-6.
Liver abscess is uncommon in children. The purpose of this study is to evaluate the predisposing factors, pathogens, duration of hospitalization, and the managements of liver abscess in children. From 1986 to 2001, fifteen children were admitted to our hospital under the diagnosis of liver abscess. Thirteen cases were older than 8 years old and two were younger than one year old. Fever (15/15, 100%) and abdominal pain (13/15, 87%) were the most common symptoms. Twelve patients (80%) had prolonged fever (fever for 7 days or longer before diagnosis). Eleven (73%) cases were cryptogenic in origin. Most of the microorganisms were obtained solely from cultures of pus. Klebsiella pneumoniae was the most common organism isolated (6/15, 40%). Beside administration of antibiotics, percutaneous catheter drainage (PCD) was performed in 11 patients (73%); only one underwent surgical intervention due to poor response to PCD management. All of our patients were surviving after at least one year follow-up. In conclusion, liver abscess should be suspected in the patients with prolonged fever of unknown origin and abdominal pain. PCD combined with adequate antibiotics were sufficient for therapy of liver abscess in most cases. K. pneumoniae was the most common isolated pathogen in southern Taiwan.
肝脓肿在儿童中并不常见。本研究的目的是评估儿童肝脓肿的易感因素、病原体、住院时间及治疗方法。1986年至2001年，我院共收治15例诊断为肝脓肿的儿童患者。其中13例年龄大于8岁，2例年龄小于1岁。发热（15/15，100%）和腹痛（13/15，87%）是最常见的症状。12例患者（80%）有长期发热（诊断前发热7天或更长时间）。11例（73%）病例病因不明。大多数微生物仅从脓液培养物中获得。肺炎克雷伯菌是最常见的分离菌（6/15，40%）。除了使用抗生素外，11例患者（73%）进行了经皮导管引流（PCD）；只有1例因对PCD治疗反应不佳而接受了手术干预。所有患者在至少1年的随访后均存活。总之，对于不明原因长期发热和腹痛的患者应怀疑肝脓肿。在大多数情况下，PCD联合足量抗生素足以治疗肝脓肿。肺炎克雷伯菌是台湾南部最常见的分离病原体。
