Varied treatment responses in liver abscesses at a malaysian teaching hospital: a case series

Introduction: Pyogenic liver abscesses (PLA) are increasingly prevalent in Malaysia, with a national incidence of 1.43 cases per 100,000 people per year. Common causative organisms from the gut include Escherichia coli, Enterobacteriaceae, Klebsiella pneumoniae and anaerobes. Untreated PLA can be fatal, however with the development of modern diagnostic modalities, treatment approaches and antimicrobial therapies, mortality can be significantly reduced. Case series: We include four patients who were admitted to a tertiary teaching hospital, detailing their clinical characteristics, treatment approaches and outcomes during their hospital stay. All four patients had a common risk factor of diabetes mellitus, presenting with non-specific symptoms of anorexia with or without fevers and had a liver abscess greater than 5cm in size. Only two patients underwent percutaneous catheter drainage and the duration of antibiotics ranged from 44 to 94 days in total. Conclusion: Management of PLA remain challenging due to its heterogeneity in causative organisms and treatment responses which calls for a better consensus on antibiotic duration and methods for monitoring treatment response.

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