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February 8, 1947

MULTIPLE PYOGENIC ABSCESSES OF THE LIVER: Cure by Penicillin in Case Due to Anaerobic Streptococci

Author Affiliations

New Orleans

From the Surgical and Medical Services of Touro Infirmary.

JAMA. 1947;133(6):395-396. doi:10.1001/jama.1947.62880060013007d

Abscesses of the liver may be classified in two main groups, (1) amebic (tropical) and (2) pyogenic. Amebic hepatitis is the result of invasion of the biliary radicles by Endameba histolytica. The amebas are usually present in the large bowel and are carried through the portal veins to the liver, where a specific hepatitis occurs. Further discussion of this type of hepatic abscess is not in the scope of this paper.

Hepatitis or hepatic abscesses due to pyogenic microorganisms present a more complex clinical picture. Invasion of the liver may occur by any of four routes:1 (1) infection from areas drained by the portal system; (2) direct spread from contiguous structures; (3) penetrating trauma, and (4) bloodborne infection. In many instances no antecedent focus of infection can be demonstrated.

A great deal has been written on pyogenic hepatic abscesses, but detailed bacteriologic studies have been neglected. In an extensive