Rare complications of pyogenic liver abscess.

Chong V H, Zainal-Abidin Z, Hassan H, Chong C F. Singapore Med J 2010; 51(10): e169-e172

Pyogenic liver abscess (PLA) is still associatedwith significant morbidity and mortality. With advances in imaging, most cases are now diagnosed early and effectively treated. However, complications, although considered rare, may still occur. We report three cases of PLA that were associated with rare and significant complications. Two patients had an abscess rupture that resulted in pyopericardium in one patient and sub-diaphragmatic abscess in the other. Another patient with Klebsiella pneumoniae PLA had bilateral endophthalmitis that resulted in blindness. Death secondary to overwhelming sepsis occurred in the patient with Escherichia coli-related pyopericardium. Delay in diagnosis contributed to the complications in two of the patients.

Correspondence: Chong VH, Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam, email: chongvuih@yahoo.co.uk.