背景：化膿性肝膿瘍如果沒有治療，會有高度的致死率。這個研究的目的在於評估單發性及多發性肝膿瘍的相似性及差異性。 材料與方法：33位符合診斷標準的肝膿瘍病患被收在這個研究之中，其中25位為單發性膿瘍，8位為多發性膿瘍。病人的基本資料、原有之疾病、臨床表現、致病源、治療方法及治療結果被評估並記錄，然後在根據單發型及多發型兩組進行比較。 結果：在兩組之中皆發現肝膿瘍好發於男性，而糖尿病是病患最常有的原有疾病。病患之症狀及徵候並沒有專一性；其中的表現以發燒、腹痛及寒顫最為常見。膿瘍及血液培養發現大多數為單一致病菌，其中以克氏肺炎桿菌(Klebsiella pneumoniae)最常見。經皮抽吸術所需平均天數為13天，其成功率為84%。有一位單發型病患死亡；四位單發型病患有疾病復發的現象。 結論：單發性及多發性肝膿瘍之間並沒有明顯之差異，早期診斷、及時治療是這類疾病的必要處理方式。早期診斷的關鍵在於將任何不明原因的發燒及腹痛列入肝膿瘍的鑑別診斷，特別是糖尿病患者。 Background: Pyogenic liver abscess, without treatment, carry a high mortality rate. The purpose of this study was to evaluate the similarities and differences between patients with single and multiple abscesses. Materials and Methods: Thirty-three patients with pyogenic liver abscess who fulfilled the described criteria were studied, 25 had a single abscess and 8 had multiple abscesses. Demographic characteristics, underlying disease, clinical manifestations, microbiology, methods of treatment, and outcome were evaluated and compared between the two groups. Results: In both groups, male predominated and diabetes mellitus was the most common underlying disease. Symptoms and signs were nonspecific; fever, abdominal pain and chills were common. Abscess and blood cultures yield higher proportion of monomicrobial. Klebsiella pneumoniae was the most common isolated organism. Average duration of percutaneous drainage was 13 days and overall success rate of percutaneous treatment was 84%. One patient died and four recurrences were noted in the single abscess group. Conclusions: No significant differences were found between the two groups. Early diagnosis and prompt treatment are the prerequisites for cure. The key to early diagnosis is consideration of liver abscess in the different diagnosis of any unexplained febrile illness with abdominal pain especially in diabetic patients.
