Prospective study ofStreptococcus milleri hepatic abscess

Publisher Website
Google Scholar
Abstract
Thirty-seven cases of microbiologically demonstrated pyogenic hepatic abscess were observed in a prospective study over a seven-year period. Biliary disease was the most common source of liver abscess (42%).Streptococcus milleri was the most common cause of hepatic abscess, accounting for 51% of the cases. Hepatic abscess is due toStreptococcus milleri clinically distinct from other forms of pyogenic liver abscess due to its torpid nature and the longer duration of its symptoms [42 vs. 11 days]. Occult hepatic abscess should be suspected if the blood culture is positive forStreptococcus milleri, since 28% of bacteremia cases due toStreptococcus milleri stem from hepatic abscesses. It is important to distinguishStreptococcus milleri from other members of the viridans streptococci group, which are frequently isolated as contaminants, but only exceptionally cause hepatic abscess. Unlike other pyogenic hepatic abscesses, those caused byStreptococcus milleri are frequently monomicrobial (79%). In the present study, empirical therapy of pyogenic hepatic abscess always included a drug that is effective againstStreptococcus milleri.