Difficulties in differentiating amebic from pyogenic liver abscess

Abstract

LIVER abscess, despite refinement in diagnostic and therapeutic aids, remains a serious illness with a high morbidity and mortality. Due to the pitfalls in differentiating amebic from pyogenic abscess and the marked difference in the mortality, we have reviewed the cases of liver abscess at Parkland Memorial Hospital since 1943 in an effort to establish clinical and laboratory features which might be used to differentiate the two. At the same time, a reasonable approach to therapy of hepatic abscesses might be established. Methods Cases were obtained by review of the infectious disease service and record room files and autopsy protocols at Parkland Memorial Hospital from 1943 to 1966. Only patients with macroscopic abscesses were selected for this review. Based on the following features, the cases were divided into amebic and pyogenic groups. Patients were classified as having amebic abscesses if they manifested one of the following: (1) demonstration of amebae