Mehendiratta Vaibhav, McCarty Brandon Chase, Gomez Luis, Graviss Edward A, Musher Daniel M
Department of Medicine/Infectious Diseases Section, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA.
J Infect. 2007 Feb;54(2):122-8. doi: 10.1016/j.jinf.2006.03.004. Epub 2006 May 5.
To review the experience with percutaneous aspiration of abscesses at a general, tertiary care hospital from 2000 to 2005.
Computerized medical records of 90 patients who underwent radiologically guided drainage of 92 fluid collections were reviewed for demographic data, co-morbid conditions, location, radiographic imaging characteristics and culture results and to determine the long-term outcome of the procedure.
Sixty-seven of 92 (73%) abscesses were cured without the need for open surgical drainage; 44 were cured within 14 days, and 23 had delayed resolution requiring prolonged antibiotics and/or a second drainage. Of the abscesses 85% were drained using a catheter in situ, the remaining aspirated using a needle. Twenty-five (27%) of the 92 abscesses failed percutaneous drainage, requiring open surgical drainage or lead to sepsis and death. Neither co-morbid conditions nor the location of abscesses affected the outcome of drainage. Patients who had sterile cultures of aspirated material after receiving antibiotics prior to the procedure had a significantly higher cure rate than otherwise (P<0.05). Catheter drainage was associated with a significantly higher cure rate than was needle aspiration (P<0.05).
Percutaneous drainage, along with appropriate antibiotics, is an effective approach to treat deep abscesses. Drainage, itself, is the major determinant of outcome, rather than the location, characteristics of the abscess or condition of the patient prior to the procedure.
