Sarawat Deepika, Varghese Gerlin, Sahu Chinmoy, Tejan Nidhi, Singh Surender, Patel Sangram S, Khan Mohd R
Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, India.
Dept of Hepatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, India.
J Clin Exp Hepatol. 2023 Nov-Dec;13(6):1025-1031. doi: 10.1016/j.jceh.2023.07.002. Epub 2023 Jul 7.
Amoebic liver abscess (ALA) and pyogenic liver abscesses (PLA) are the most common causes of liver abscess in developing and developed countries, respectively. Although incidence of liver abscess is low, but mortality is high amongst the patients due to delayed diagnosis. The study was done to find out the prevalence of amoebic and PLA among patients of liver abscess. The clinical, personal, and demographical details were also evaluated to find out the risk factor(s) associated with ALA and PLA, respectively.
A retrospective study was conducted to find the prevalence of amoebic and PLA. Clinical, demographic, personal details were evaluated from hospital records. Laboratory parameters such as total leucocyte count, platelets, bilirubin, ESR (Erythrocyte Sedimentation Rate), hemoglobin, glycosylated hemoglobin (HbA1c), alkaline phosphate (ALP), Aspartate aminotransferase (SGOT/AST), Alanine aminotransferase (SGPT/ALT), serum albumin, bilirubin levels, and procalcitonin were recorded. The Ultrasonography (USG) findings regarding the size, location, volume, and number of abscesses were also analyzed.
Total of 107 patients of liver abscess were evaluated, and 61.6% of patients were of amoebic etiology, and 25.3% were of pyogenic etiology. Males of 20-60 years of age were predominantly affected with right upper quadrant pain and fever as the most common presentations. ALA patients were found to have solitary abscess in the right lobe involving 6th and 7th segments, with decreased hemoglobin, hyperbilirubinemia, elevated ALP and SGOT, with normal SGPT, and addiction to alcohol. PLA patients had increased HbA1c, increased PCT values, low serum albumin levels, and low platelet-to-white blood cell values. The most common bacteria causing PLA was (n = 8) followed by (n = 5). Mortality was seen in 6 patients.
Liver abscess is found to have relatively high mortality and morbidity. Therefore, early diagnosis is the only method to prevent mortality and morbidity in these patients. Since the presentation is very nonspecific, evaluation of certain risk factors and laboratory parameters can aid in the diagnosis.
阿米巴肝脓肿（ALA）和化脓性肝脓肿（PLA）分别是发展中国家和发达国家肝脓肿最常见的病因。尽管肝脓肿的发病率较低，但由于诊断延迟，患者的死亡率较高。本研究旨在了解肝脓肿患者中阿米巴肝脓肿和化脓性肝脓肿的患病率。还评估了临床、个人和人口统计学细节，以分别找出与阿米巴肝脓肿和化脓性肝脓肿相关的危险因素。
进行一项回顾性研究以确定阿米巴肝脓肿和化脓性肝脓肿的患病率。从医院记录中评估临床、人口统计学和个人细节。记录实验室参数，如白细胞总数、血小板、胆红素、血沉（红细胞沉降率）、血红蛋白、糖化血红蛋白（HbA1c）、碱性磷酸酶（ALP）、天冬氨酸转氨酶（SGOT/AST）、丙氨酸转氨酶（SGPT/ALT）、血清白蛋白、胆红素水平和降钙素原。还分析了超声检查（USG）关于脓肿大小、位置、体积和数量的结果。
共评估了107例肝脓肿患者，其中61.6%的患者病因是阿米巴性的，25.3%是化脓性的。20至60岁的男性受影响最为主要，右上腹疼痛和发热是最常见的症状。发现阿米巴肝脓肿患者在右叶有单个脓肿，累及第6和第7段，血红蛋白降低、高胆红素血症、碱性磷酸酶和天冬氨酸转氨酶升高，谷丙转氨酶正常，且有酗酒习惯。化脓性肝脓肿患者糖化血红蛋白升高、降钙素原值升高、血清白蛋白水平低以及血小板与白细胞比值低。导致化脓性肝脓肿最常见的细菌是（n = 8），其次是（n = 5）。6例患者出现死亡。
发现肝脓肿的死亡率和发病率相对较高。因此，早期诊断是预防这些患者死亡和发病的唯一方法。由于临床表现非常不具特异性，对某些危险因素和实验室参数的评估有助于诊断。
