Pyogenic Liver Abscess Due to Microaerophilic Streptococci

Abstract

Two cases of liver abscess due to micro-aerophilic streptococci are described, and 15 cases from the literature are reviewed. The true incidence of anaerobic organisms and anaerobic cocci specifically in cases of liver abscess is unknown because adequate anaerobic cultures often are not done. An important, frequently overlooked indication of anaerobic infection is putrid or foul-smelling purulent exudate. Liver photoscanning proved to be the most useful procedure leading to a diagnosis in our cases, and was very helpful in planning the surgical approach. The primary treatment of pyogenic liver abscess is surgical drainage, and this is best accomplished with the posterior approach in 80% of the cases. Antibiotic therapy for liver abscess in general and for infections due to anaerobic cocci is discussed.