IDDF2018-ABS-0156 Clinical profile and factors affecting outcome of children with hepatic abscess

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Abstract

Background

Hepatic abscess typically presents with nonspecific symptoms which contribute to late diagnosis and treatment, hence complicated course and outcome. Determining the factors affecting complications and outcome among children with hepatic abscess can help improve the management of these patients. The objective is to determine the clinical profile of children with hepatic abscess and the factors affecting their complications and outcome.

Methods

This is a retrospective cohort study. Chart review was done in December 2016 among children 0 to <19 years old with a diagnosis of a hepatic abscess on imaging from 1997–2015. Demographic, clinical and diagnostic data gathered were correlated with the outcome and complications.

Results

Thirty cases were identified in 19 years, but only 25 charts were reviewed. Mean age in years was 5.27 4.80 SD with male predominance. Fever (96%) and abdominal pain (60%) were common symptoms with Staphylococcus aureus (56%) as the most frequent growth on hepatic abscess culture. Anaemia (76%) and leukocytosis (96%), as well as solitary (76%), large abscesses >5 cms (60%) involving the right lobe (72%), were also common. Most were treated with antibiotics alone (60%). All patients improved without mortalities, while pleural effusion (67%) was a commonly seen complication. Only male gender was significantly associated with complications both on Chi-square (p 0.004) and logistic regression (p 0.008).

Conclusions

Hepatic abscess is common among the young and male population, manifesting as fever with anaemia and leukocytosis, and Staphylococcus aureus commonly growing on hepatic abscess culture. Most were complicated by pleural effusion with no deaths reported. Male gender had a significant association with complications.

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