Pyogenic liver abscess:: changes in etiology, diagnosis and treatment over 18 years

Background. There are no detailed studies in our country on the impact of modern imaging techniques on diagnosis, treatment and prognosis of pyogenic liver abscesses. Material and methods. All patients with the diagnosis of PLA from 1981 to 1998 were included in the study. The study was divided in two periods: 1981 to 1989 and 1990 to 1998. Results. Compared with the first time period, the following was observed from 1990 to 1998: the mean age was higher (52 versus 65 years, p = 0.006), infections with identified source increased (33% versus 74%, p = 0.003), diagnosis was earlier (13 versus 3 days, p = 0.0002), modern imaging techniques were used more frequently (17% versus 96%, p = 0.002), the proportion of recovered microorganisms increased (53% versus 88%, p = 0.002), as well as use of percutaneous drainage (0% versus 37%, p = 0.002) and the prognosis was better (mortality rate 40% versus 10%, p = 0.01). Conclusions. Relevant changes were observed among patients in our hospital in the nineties regarding epidemiology, management and prognosis of PLAs. Part of these changes are due to a higher use of new imaging techniques.