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Difficulties in Differentiating Amebic From Pyogenic Liver Abscess

Difficulties in Differentiating Amebic From Pyogenic Liver Abscess Abstract LIVER abscess, despite refinement in diagnostic and therapeutic aids, remains a serious illness with a high morbidity and mortality. Due to the pitfalls in differentiating amebic from pyogenic abscess and the marked difference in the mortality, we have reviewed the cases of liver abscess at Parkland Memorial Hospital since 1943 in an effort to establish clinical and laboratory features which might be used to differentiate the two. At the same time, a reasonable approach to therapy of hepatic abscesses might be established. Methods Cases were obtained by review of the infectious disease service and record room files and autopsy protocols at Parkland Memorial Hospital from 1943 to 1966. Only patients with macroscopic abscesses were selected for this review.Based on the following features, the cases were divided into amebic and pyogenic groups. Patients were classified as having amebic abscesses if they manifested one of the following: (1) demonstration of amebae References 1. Ogden, W.W.; Hunter, P.; and Rines, J.D.: Pyogenic Liver Abscess , J Louisiana Med Soc 114: 139, 1962. 2. Sherman, J.D., and Robbins, S.L.: Changing Trends in the Casuistics of Hepatic Abscess , Amer J Med 28:943, 1960.Crossref 3. Ochsner, A., and DeBakey, M.: Amebic Hepatitis and Hepatic Abscess , Surgery 13:460, 1943. 4. Craig, C.F.: The Etiology, Diagnosis and Treatment of Amebiosis , Baltimore: Williams & Wilkins Company, 1944. 5. Cronin, K.: Pyogenic Abscess of the Liver , Gut 2:53, 1961.Crossref 6. Ochsner, A., and DeBakey, M.: Pyogenic Abscess of Liver , Amer J Surg 40:292, 1938.Crossref 7. Schiff, L.: Diseases of the Liver , Philadelphia: J. B. Lippincott Company, 1956. 8. Gollin, F.F.; Sims, J.L.; and Cameron, J.R.: Liver Scanning and Liver Function Tests: Comparative Study , JAMA 187:111, 1964.Crossref 9. Schwan, B.M.; Block, M.A.; and Eyler, W.R.: Liver Abscess: Rose Bengal I131 Hepatic Photoscan in Diagnosis and Management , JAMA 187:708, 1964. 10. Ibrahim, M.S., and Abdel-Wahal, M.F.: Detection of Amebic Liver Abscess by Isotope Scanning , Brit Med J 1:1325, 1963.Crossref 11. Wilmot, A.J.; Powell, S.J.; and Adams, E.B.: Chloroquine Compared With Chloroquine and Emetine Combined in Amebic Liver Abscess , Amer J Trop Med 8:623, 1959. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Difficulties in Differentiating Amebic From Pyogenic Liver Abscess

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00290190117010
Publisher site
See Article on Publisher Site

Abstract

Abstract LIVER abscess, despite refinement in diagnostic and therapeutic aids, remains a serious illness with a high morbidity and mortality. Due to the pitfalls in differentiating amebic from pyogenic abscess and the marked difference in the mortality, we have reviewed the cases of liver abscess at Parkland Memorial Hospital since 1943 in an effort to establish clinical and laboratory features which might be used to differentiate the two. At the same time, a reasonable approach to therapy of hepatic abscesses might be established. Methods Cases were obtained by review of the infectious disease service and record room files and autopsy protocols at Parkland Memorial Hospital from 1943 to 1966. Only patients with macroscopic abscesses were selected for this review.Based on the following features, the cases were divided into amebic and pyogenic groups. Patients were classified as having amebic abscesses if they manifested one of the following: (1) demonstration of amebae References 1. Ogden, W.W.; Hunter, P.; and Rines, J.D.: Pyogenic Liver Abscess , J Louisiana Med Soc 114: 139, 1962. 2. Sherman, J.D., and Robbins, S.L.: Changing Trends in the Casuistics of Hepatic Abscess , Amer J Med 28:943, 1960.Crossref 3. Ochsner, A., and DeBakey, M.: Amebic Hepatitis and Hepatic Abscess , Surgery 13:460, 1943. 4. Craig, C.F.: The Etiology, Diagnosis and Treatment of Amebiosis , Baltimore: Williams & Wilkins Company, 1944. 5. Cronin, K.: Pyogenic Abscess of the Liver , Gut 2:53, 1961.Crossref 6. Ochsner, A., and DeBakey, M.: Pyogenic Abscess of Liver , Amer J Surg 40:292, 1938.Crossref 7. Schiff, L.: Diseases of the Liver , Philadelphia: J. B. Lippincott Company, 1956. 8. Gollin, F.F.; Sims, J.L.; and Cameron, J.R.: Liver Scanning and Liver Function Tests: Comparative Study , JAMA 187:111, 1964.Crossref 9. Schwan, B.M.; Block, M.A.; and Eyler, W.R.: Liver Abscess: Rose Bengal I131 Hepatic Photoscan in Diagnosis and Management , JAMA 187:708, 1964. 10. Ibrahim, M.S., and Abdel-Wahal, M.F.: Detection of Amebic Liver Abscess by Isotope Scanning , Brit Med J 1:1325, 1963.Crossref 11. Wilmot, A.J.; Powell, S.J.; and Adams, E.B.: Chloroquine Compared With Chloroquine and Emetine Combined in Amebic Liver Abscess , Amer J Trop Med 8:623, 1959.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1967

References