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1.
Anaerobe ; 69: 102344, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33588043

RESUMEN

Fusobacterium necrophorum, a Gram-negative anaerobe, is the primary etiologic agent of liver abscesses of beef cattle. The bacterium, a member of the microbial community of the rumen, travels to the liver via portal circulation to cause abscesses. The severity of liver abscesses vary from mild with one or two small abscesses to severe with medium to large multiple abscesses. Leukotoxin, a secreted protein, is the critical virulence factor involved in the infection. Our objective was to compare leukotoxin production between strains of F. necrophorum isolated from mild and severe liver abscesses collected from slaughtered cattle. The quantification of leukotoxin was based on assays to measure cytotoxicity and protein antigen concentration. One-hundred strains, 50 from mild and 50 from severe abscesses, were utilized in the study. Cell-free supernatants were prepared from cultures grown in anaerobic broth at 9 and 24 h incubations. The leukotoxic activity was quantified by measuring cytotoxicity based on the release of lactic dehydrogenase from bovine lymphocyte cells, BL3, treated with the culture supernatant. Leukotoxin protein concentration was quantified by a sandwich ELISA assay with a leukotoxin-specific monoclonal antibody as the capture antibody. The leukotoxin activity and concentration were highly variable among the strains within each severity of liver abscesses. Although the leukotoxic activity was unaffected by incubation time, leukotoxin protein concentration was consistently higher at 24 h compared to 9 h incubation. Strains from severe liver abscesses had significantly higher leukotoxic activity and higher protein concentration compared to strains from mild liver abscesses (P < 0.0001) at both 9 and 24 h culture supernatants. Across all strains, the correlation coefficients between leukotoxic activity and leukotoxin concentration at 9 and 24 h were 0.14 (P = 0.17) and 0.47 (P < 0.0001), respectively. In conclusion, strains isolated from severe liver abscesses had significantly higher leukotoxic activities and leukotoxin protein concentrations compared to strains isolated from mild liver abscesses.


Asunto(s)
Exotoxinas/biosíntesis , Infecciones por Fusobacterium/microbiología , Infecciones por Fusobacterium/fisiopatología , Fusobacterium necrophorum/aislamiento & purificación , Fusobacterium necrophorum/metabolismo , Absceso Hepático/microbiología , Absceso Hepático/fisiopatología , Animales , Bovinos , Enfermedades de los Bovinos/microbiología , Enfermedades de los Bovinos/fisiopatología , Fusobacterium necrophorum/genética , Variación Genética , Genotipo , Índice de Severidad de la Enfermedad
2.
BMJ Case Rep ; 13(7)2020 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-32699056

RESUMEN

Extramedullary haematopoiesis (EMH) is defined as haematopoiesis occurring in organs outside the bone marrow. The liver is one of the rare sites of EMH, and to the best of our knowledge, a few cases of adult EMH of the liver have been reported in the last 20 years. Here, we reported the case of a 68-year-old man with a known history of myelofibrosis presented with vague abdominal pain. An abdominal CT scan showed a hypoattenuating periportal mass encasing the portal vein. The final diagnosis of EMH was made through the histopathological examination. This is a rare presentation of EMH, which may be easily mistaken for other pathologies such as metastases. Familiarity with this type of presentation aids in correctly diagnosing it in an appropriate clinical setting.


Asunto(s)
Hematopoyesis Extramedular , Absceso Hepático/fisiopatología , Vena Porta/diagnóstico por imagen , Vena Porta/fisiopatología , Mielofibrosis Primaria/complicaciones , Mielofibrosis Primaria/diagnóstico , Mielofibrosis Primaria/fisiopatología , Anciano , Humanos , Absceso Hepático/diagnóstico por imagen , Masculino , Resultado del Tratamiento
3.
Br Med Bull ; 132(1): 45-52, 2019 12 11.
Artículo en Inglés | MEDLINE | ID: mdl-31836890

RESUMEN

INTRODUCTION: Liver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The pathophysiology of abscesses is different depending on the etiology and requires different strategies for diagnosis and management. This paper discusses pathophysiology and epidemiology, the current diagnostic approach and its limitations and management of liver abscess in low resource settings. SOURCES OF DATA: We searched PubMed for relevant reviews by typing the following keywords: 'amoebic liver abscess' and 'pyogenic liver abscess'. AREAS OF AGREEMENT: Amoebic liver abscess can be treated medically while pyogenic liver abscess usually needs to be percutaneously drained and treated with effective antibiotics. AREAS OF CONTROVERSY: In an LMIC setting, where misuse of antibiotics is a recognized issue, liver abscesses are a therapeutic conundrum, leaving little choices for treatment for physicians in low capacity settings. GROWING POINTS: As antimicrobial resistance awareness and antibiotic stewardship programs are put into place, liver abscess management will likely improve in LMICs provided that systematic adapted guidelines are established and practiced. AREAS TIMELY FOR DEVELOPING RESEARCH: The lack of a quick and reliable diagnostic strategy in the majority of LMIC makes selection of appropriate treatment challenging.


Asunto(s)
Absceso Hepático/diagnóstico , Absceso Hepático/terapia , Área sin Atención Médica , Antibacterianos/uso terapéutico , Humanos , Absceso Hepático/microbiología , Absceso Hepático/fisiopatología , Absceso Hepático Amebiano/diagnóstico , Absceso Hepático Amebiano/microbiología , Absceso Hepático Amebiano/fisiopatología , Absceso Hepático Amebiano/terapia , Absceso Piógeno Hepático/diagnóstico , Absceso Piógeno Hepático/microbiología , Absceso Piógeno Hepático/fisiopatología , Absceso Piógeno Hepático/terapia , Pronóstico
6.
J Int Med Res ; 46(9): 3824-3836, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30091401

RESUMEN

Objective To enhance theoretical support of pyogenic liver abscess (PLA) treatment by comparing characteristics of patients with either PLA with an identified infectious origin (non-cryptogenic) or PLA with no obvious underlying cause (cryptogenic). Methods This retrospective study included all first episodes of PLA in adults admitted to a tertiary hospital between 2009 and 2016. Relevant clinical data were collected for patients with cryptogenic or non-cryptogenic PLA and compared across a number of characteristics. Results In all, 178 patients were included: 111 cases (62.4%) of cryptogenic PLA, and 67 cases (37.6%) of non-cryptogenic PLA. Diabetes mellitus was significantly more prevalent in patients with cryptogenic PLA than those with non-cryptogenic PLA. The proportion of multidrug resistance/poly-microbial infection was significantly lower and Klebsiella pneumoniae infection was significantly higher in the cryptogenic versus non-cryptogenic PLA group. Metastatic infection occurred in four patients with cryptogenic PLA only, and all had diabetes and K. pneumoniae infection. Multivariate logistic regression analysis revealed that male sex, diabetes and K. pneumoniae were independent predictors for cryptogenic PLA. Conclusions Cryptogenic and non-cryptogenic PLA have distinctly different characteristics, suggesting a potential need for different treatment approaches.


Asunto(s)
Absceso Piógeno Hepático/diagnóstico , Adulto , Anciano , China , Complicaciones de la Diabetes/complicaciones , Complicaciones de la Diabetes/fisiopatología , Farmacorresistencia Bacteriana Múltiple/fisiología , Femenino , Humanos , Absceso Hepático/diagnóstico , Absceso Hepático/etiología , Absceso Hepático/fisiopatología , Absceso Piógeno Hepático/complicaciones , Absceso Piógeno Hepático/microbiología , Absceso Piógeno Hepático/fisiopatología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
8.
Balkan Med J ; 34(5): 469-472, 2017 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-28443586

RESUMEN

BACKGROUND: Salmonella enterica serovar Enteritidis is among the most reported serotypes of Salmonella species worldwide, but is rarely reported as the causative agent of a liver abscess. CASE REPORT: We present a patient with an abdominal blunt trauma. An initial abdominal computed tomography scan revealed a rupture of the right kidney and of the liver. Two days later, his physical state deteriorated and a new computed tomography scan was obtained. An extremely large 8-centimetre liver abscess was verified. Due to the unsatisfying response to antibiotic therapy and percutaneous drainage, we operated on the patient. An appendectomy, cholecystectomy and bisegmental liver resection were performed. An intraoperative swab from the abscess was positive for Salmonella enterica serovar Enteritidis. The patient was given intravenous ciprofloxacine. The post-operative course was complicated by a Coagulase-negative Staphylococcus infection of the wound, which improved with antibiotic therapy. CONCLUSION: Blunt abdominal trauma may initiate an unpredictable course of the disease in chronic Salmonella carriers.


Asunto(s)
Absceso Hepático/fisiopatología , Salmonella enteritidis/patogenicidad , Heridas no Penetrantes/complicaciones , Abdomen/microbiología , Adulto , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Apendicectomía , Colecistectomía , Ciprofloxacina/farmacología , Ciprofloxacina/uso terapéutico , Humanos , Absceso Hepático/etiología , Absceso Hepático/cirugía , Masculino , Infecciones por Salmonella , Salmonella enteritidis/efectos de los fármacos
9.
Medicine (Baltimore) ; 95(49): e5606, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27930585

RESUMEN

To investigate the incidence and outcome of major complication following conventional transarterial embolization/chemoembolization (TAE/TACE) therapy for hepatocellular carcinoma (HCC).From May 2010 to May 2016, all patients with major complication following conventional TAE/TACE for HCC were included. Major complication was defined as admission to a hospital for therapy, an unplanned increase in the level of care, prolonged hospitalization, permanent adverse sequelae, or death after conventional TAE/TACE therapy by Society of Interventional Radiology.During the study period, a total of 2863 TAE/TACE procedures were performed among 1120 patients, and a total of 24 patients (21 male and 3 female) developed major complication with the incidence of 2.1% (24/1120) per patient and 0.84% (24/2863) per TAE/TACE procedure. The major complications were liver rupture (n = 6), liver abscess (n = 5), femoral artery pseudoaneurysm (n = 3), cholecystitis (n = 2), biloma (n = 2), pulmonary embolism (n = 2), and 1 each of the following: cerebral lipiodol embolism, tumor lysis syndrome, partial intestinal obstruction, gallbladder perforation. The mean interval from last TAE/TACE procedure to the diagnosis of major complication was 11.1 ±â€Š7.7 days. The treatments of the complications were conservative treatment (n = 12), conservative treatment plus percutaneous drainage (n = 3), ultrasound-guided thrombin injection (n = 3), conservative treatment plus TAE (n = 2), and conservative treatment plus surgery (n = 2). Of the 24 patients, 20 patients were recovered, and remaining 4 patients were died of major complications; therefore, the mortality rate of major complication was 16.7% (4/24).Major complication following conventional TAE/TACE therapy is uncommon; the outcomes are benign of most major complications, but some are mortality.


Asunto(s)
Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica/efectos adversos , Infusiones Intraarteriales/efectos adversos , Neoplasias Hepáticas/terapia , Hígado/lesiones , Adulto , Anciano , Aneurisma Falso/etiología , Aneurisma Falso/fisiopatología , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/mortalidad , Quimioembolización Terapéutica/métodos , Estudios de Cohortes , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/métodos , Femenino , Arteria Femoral , Estudios de Seguimiento , Humanos , Infusiones Intraarteriales/métodos , Tiempo de Internación , Absceso Hepático/etiología , Absceso Hepático/fisiopatología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidad , Masculino , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Embolia Pulmonar/etiología , Embolia Pulmonar/fisiopatología , Estudios Retrospectivos , Medición de Riesgo , Rotura Espontánea/etiología , Rotura Espontánea/fisiopatología , Tasa de Supervivencia , Resultado del Tratamiento , Adulto Joven
12.
Mymensingh Med J ; 23(4): 796-9, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25481604

RESUMEN

Hepatobiliary ascariasis is common in developing countries where there is a low standard of public health and hygiene. We are reporting a rare case of ascariasis which induced multiple liver abscesses in a post menopausal woman who presented with fever, anorexia, nausea, vomiting and mild hepatomegaly. Ultrasonography revealed biliary ascariasis with multiple hepatic abscesses. Laparoscopic drainage of hepatic abscesses was done and microscopic examination of drainage materials showed decorticated eggs of Ascaris Lumbricoides. The post operative recovery of the patient was uneventful. Ultrasonography is a reliable modality to diagnose and follow up of such cases.


Asunto(s)
Antiparasitarios/administración & dosificación , Ascariasis , Ascaris lumbricoides/aislamiento & purificación , Enfermedades de las Vías Biliares , Laparoscopía/métodos , Absceso Hepático , Succión/métodos , Animales , Ascariasis/complicaciones , Ascariasis/diagnóstico , Ascariasis/fisiopatología , Ascariasis/terapia , Enfermedades de las Vías Biliares/complicaciones , Enfermedades de las Vías Biliares/diagnóstico , Enfermedades de las Vías Biliares/fisiopatología , Enfermedades de las Vías Biliares/terapia , Femenino , Humanos , Hígado/diagnóstico por imagen , Hígado/parasitología , Absceso Hepático/diagnóstico , Absceso Hepático/etiología , Absceso Hepático/fisiopatología , Absceso Hepático/cirugía , Persona de Mediana Edad , Posmenopausia , Resultado del Tratamiento , Ultrasonografía
13.
Med Pregl ; 67(1-2): 55-9, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24964570

RESUMEN

INTRODUCTION: Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. These tumors represent more than 80% of all mesenchymal tumors found in the gastrointestinal tract, though they account for only approximately 3% of all gastrointestinal malignancies. Literature offers case reports, which describe symptomatic gastrointestinal stromal tumors and they generally represent patients with larger tumors. CASE REPORT: We present the case of a small gastrointestinal stromal tumor in a 40-year-old man, with associated giant liver hemangioma and fever, and with history of abdominal discomfort and fever. Clinical examination revealed hepatosplenomegaly, palpable mass in the right lower abdomen, and signs of neurofibromatosis type 1 (Morbus von Recklinghausen). Computed tomography revealed a giant tumor in the right lobe of the liver. Magnetic resonance showed abscess in the hemangioma of the liver. An intestinal tumor was incidentally found and excised during surgical laparotomy. An intestinal gastrointestinal stromal tumor was revealed by histopathology and confirmed by immunohistochemistry. Although a multidisciplinary team proposed surgical removal of the liver tumor mass, the surgeons decided to follow up the patient because of a high risk of new intervention. CONCLUSION: According to the available data, this is a very rare case of small intestinal gastrointestinal stromal tumor, with symptoms of fever and giant abscess in the liver hemangioma.


Asunto(s)
Tumores del Estroma Gastrointestinal , Hemangioma , Neoplasias del Íleon , Absceso Hepático , Neoplasias Hepáticas , Neurofibromatosis 1/complicaciones , Adulto , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Fiebre/etiología , Tumores del Estroma Gastrointestinal/complicaciones , Tumores del Estroma Gastrointestinal/patología , Tumores del Estroma Gastrointestinal/cirugía , Hemangioma/complicaciones , Hemangioma/patología , Hemangioma/cirugía , Humanos , Neoplasias del Íleon/complicaciones , Neoplasias del Íleon/patología , Neoplasias del Íleon/cirugía , Hígado/diagnóstico por imagen , Absceso Hepático/complicaciones , Absceso Hepático/diagnóstico , Absceso Hepático/fisiopatología , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Masculino , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Ultrasonografía
16.
Klin Khir ; (2): 22-5, 2012 Feb.
Artículo en Ucraniano | MEDLINE | ID: mdl-22629800

RESUMEN

The results of treatment of 55 patients, in whom hepatic resection was performed in 2004-2011 yrs, were analyzed. In 30 patients (main group) various kinds of hepatic resection was done for chronic abscess of the organ; in 25 (control group)--hepatic resection was conducted for hepatic tumors. In both groups o patients a comparative estimation of hepatic functional state after the organ resection was conducted in accordance to albumin level in the blood serum, the coagulogram indices, integral ration of transferases activity and a bilirubin content. There was proved, that a hepatic functional state disorders after its partial resection in patients, suffering chronic hepatic abscess, are similar to those in tumoral hepatic affection.


Asunto(s)
Hepatectomía/efectos adversos , Absceso Hepático/fisiopatología , Neoplasias Hepáticas/cirugía , Hígado/fisiopatología , Enfermedad Crónica , Femenino , Humanos , Pruebas de Función Hepática , Regeneración Hepática , Masculino , Persona de Mediana Edad
17.
Ann Saudi Med ; 31(5): 528-32, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21911993

RESUMEN

BACKGROUND AND OBJECTIVES: Liver abscess (LA) is a well-described disease in the medical literature; however, information about its characteristics and outcome in the Middle East is lacking. We compared the mode of presentation, risk factors, management and outcome of LA patients in Saudi Arabia with cases from the United Kingdom (UK). DESIGN AND SETTING: Retrospective review of LA patients from three tertiary care centers (2 from Saudi Arabia and 1 from the UK) over a period of 10 years, from 1995 to 2005. PATIENTS AND METHODS: Data collected included demographic characteristics; clinical presentation; biochemical, microbiological and radiological findings; treatment modalities; and outcome. RESULTS: A total of 83 patients were diagnosed with LA, including 48 patients from Saudi Arabia and 35 patients from the UK. The mean (SD) age was 45.2 (20.3) years for those from Saudi Arabia and 55.4 (18.8) years for those from the UK (P=.022). The majority of the patients were males (70% from Saudi Arabia and 80% from the UK). Upper abdominal pain and fever were the commonest symptoms, each reported in 87% of the cases. Alkaline phosphatase elevation was the commonest liver function abnormality, seen in 66 (80%) patients. Organisms were isolated in 43 (52%) cases and the majority of these were coliforms (58%). Amebic liver abscesses occurred in 19 (23%) patients and all of those patients were either from or had traveled recently to the Indian subcontinent. Complete resolution of the abscesses was achieved in 66 (80%) patients with aspiration and/or antibiotics, and 9 (10.8%) patients died. On multivariate analysis, underlying malignancy, hypotension and chest signs at presentation were predictors of poor outcome (P=.008, .029 and .001, respectively). CONCLUSIONS: Successful resolution of LA is achievable in the majority of the cases, although underlying malignancy is associated with poor outcome. Amebic liver abscesses must be considered in patients with a history of travel to endemic areas.


Asunto(s)
Dolor Abdominal/etiología , Fiebre/etiología , Absceso Hepático Amebiano/terapia , Absceso Hepático/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Fosfatasa Alcalina/metabolismo , Niño , Preescolar , Femenino , Humanos , Hipotensión/complicaciones , Lactante , Absceso Hepático/etiología , Absceso Hepático/fisiopatología , Absceso Hepático Amebiano/fisiopatología , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Neoplasias/complicaciones , Estudios Retrospectivos , Factores de Riesgo , Arabia Saudita , Viaje , Resultado del Tratamiento , Reino Unido , Adulto Joven
18.
Lab Invest ; 91(7): 1029-39, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21464821

RESUMEN

Capsular serotypes K1 and K2, the rmpA gene (a regulator of the mucoid phenotype) and aerobactin from Klebsiella pneumoniae have been identified as the major virulence factors for pyogenic liver abscesses with high morbidity, mortality and severe complications. The pathological mechanisms remain unclear. In this study, we compared liver immune responses and pathological changes in response to different serotypes of K. pneumoniae infections. A mouse model was used to investigate cytokine and chemokine production, histopathology findings, phagocytic uptake and mortality induced by serotypes K1 (magA(+), rmpA(+), aerobactin(+)), K2 (magA(-), rmpA(+), aerobactin(+)), K62 (magA(-), rmpA(-), aerobactin(-)) and an acapsulated isogenic K1 mutant (ΔK1, magA(+), rmpA(+), aerobactin(+)). K. pneumoniae serotypes K1 and K2 showed lower 50% lethal dose values and more phagocytic resistance to neutrophils than K62 and the ΔK1 mutant. In sequential liver samples, viable bacteria counts increased 3 h to 3 days after low-dose inoculation (<10(1) colony-forming unit (cfu)) with K1 and K2, while K62 and ΔK1 cleared rapidly and became undetectable even with high-dose inoculation (∼2.9 × 10(5) cfu). Time-dependent increases in cytokines and chemokines, including tumor necrosis factor-α, interleukin (IL)-1ß, IL-6, IL-10, keratinocyte-derived chemokines and macrophage inflammatory protein-2, were observed in the serum and liver tissue of K1- and K2-infected mice, and severe disease progression manifesting as microabscesses was also identified. K62 and ΔK1 inoculation did not result in similar immune responses and histological changes. These findings illustrate the critical role of phagocytic resistance against innate immunological defense mechanisms as well as its contribution to the development of liver abscesses.


Asunto(s)
Modelos Animales de Enfermedad , Klebsiella pneumoniae/aislamiento & purificación , Absceso Hepático/inmunología , Absceso Hepático/fisiopatología , Animales , Secuencia de Bases , Recuento de Colonia Microbiana , Cartilla de ADN , Absceso Hepático/microbiología , Masculino , Ratones , Ratones Endogámicos BALB C , Fagocitosis
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