Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department
Background: To analyze clinical spectrum of intra-abdominal abscesses in children and find helpful clinical parameters could aid physicians in earlier detection and differential diagnosis. Methods: From 2004 to 2011, we retrospectively analyzed 66 pediatric patients, aged 18 years or younger with in...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-04-01
|
| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S168411821830286X |
| _version_ | 1811221624865685504 |
|---|---|
| author | Chun-Yu Chen Mao-Jen Lin Wen-Chieh Yang Yu-Jun Chang Feng-Xia Gao Han-Ping Wu |
| author_facet | Chun-Yu Chen Mao-Jen Lin Wen-Chieh Yang Yu-Jun Chang Feng-Xia Gao Han-Ping Wu |
| author_sort | Chun-Yu Chen |
| collection | DOAJ |
| description | Background: To analyze clinical spectrum of intra-abdominal abscesses in children and find helpful clinical parameters could aid physicians in earlier detection and differential diagnosis. Methods: From 2004 to 2011, we retrospectively analyzed 66 pediatric patients, aged 18 years or younger with intra-abdominal abscesses. The data were obtained and studied: demographics, clinical presentations, etiologies, laboratory tests, microbiology, imaging studies, treatment modalities, complications and long-term outcomes. Results: There were 66 patients (mean age, 9.27 ± 4.16 years) diagnosed as intra-abdominal abscesses. The two most common presented symptoms were fever and abdominal pain (90.9%; 78.8%, respectively). Most patients presented with leukocytosis (81.8%) and elevated C-reactive protein (CRP) levels (95.5%). In patients with abscesses in solid organs, urine white blood cell counts, nitrate and leukocyte esterase were all significant parameters (all P < 0.05), and urine pH and specific gravity were both lower than those in non-solid organs (P = 0.026; P = 0.043, respectively). Escherichia coli (E. coli) was the most common organism cultured from renal abscess. Streptococcus viridans was the most common organism cultured from liver abscess. Moreover, the two most predominant bacteria in periappendical and intraperitoneal abscesses were E. coli and Bacteroides fragilis. Conclusions: We suggest that primary physicians should keep this disease in mind when children present with predisposing risk factors, fever, abdominal pain, leukocytosis and elevated CRP level. Besides, we recommend the urinary analysis or ultrasonography (US) is valuable in patients with fever and abdominal pain. Keywords: Intra-abdominal abscesses, Children, Emergency department |
| first_indexed | 2024-04-12T08:03:56Z |
| format | Article |
| id | doaj.art-e4c9198996c84505b76e46f30d4ebeff |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-04-12T08:03:56Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-e4c9198996c84505b76e46f30d4ebeff2022-12-22T03:41:15ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-04-01532283291Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency departmentChun-Yu Chen0Mao-Jen Lin1Wen-Chieh Yang2Yu-Jun Chang3Feng-Xia Gao4Han-Ping Wu5Department of Pediatric Emergency Medicine, Children's Hospital, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, TaiwanDivision of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; Department of Medicine, School of Medicine, Tzu Chi University, Hualien, TaiwanDepartment of Pediatric Emergency Medicine, Children's Hospital, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, TaiwanLaboratory of Epidemiology and Biostatistics, Changhua Christian Hospital, Changhua, TaiwanDepartment of Medical Research, Children's Hospital, China Medical University, Taichung, TaiwanDepartment of Pediatric Emergency Medicine, Children's Hospital, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, Children's Hospital, China Medical University, Taichung, Taiwan; Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan, Taiwan.Background: To analyze clinical spectrum of intra-abdominal abscesses in children and find helpful clinical parameters could aid physicians in earlier detection and differential diagnosis. Methods: From 2004 to 2011, we retrospectively analyzed 66 pediatric patients, aged 18 years or younger with intra-abdominal abscesses. The data were obtained and studied: demographics, clinical presentations, etiologies, laboratory tests, microbiology, imaging studies, treatment modalities, complications and long-term outcomes. Results: There were 66 patients (mean age, 9.27 ± 4.16 years) diagnosed as intra-abdominal abscesses. The two most common presented symptoms were fever and abdominal pain (90.9%; 78.8%, respectively). Most patients presented with leukocytosis (81.8%) and elevated C-reactive protein (CRP) levels (95.5%). In patients with abscesses in solid organs, urine white blood cell counts, nitrate and leukocyte esterase were all significant parameters (all P < 0.05), and urine pH and specific gravity were both lower than those in non-solid organs (P = 0.026; P = 0.043, respectively). Escherichia coli (E. coli) was the most common organism cultured from renal abscess. Streptococcus viridans was the most common organism cultured from liver abscess. Moreover, the two most predominant bacteria in periappendical and intraperitoneal abscesses were E. coli and Bacteroides fragilis. Conclusions: We suggest that primary physicians should keep this disease in mind when children present with predisposing risk factors, fever, abdominal pain, leukocytosis and elevated CRP level. Besides, we recommend the urinary analysis or ultrasonography (US) is valuable in patients with fever and abdominal pain. Keywords: Intra-abdominal abscesses, Children, Emergency departmenthttp://www.sciencedirect.com/science/article/pii/S168411821830286X |
| spellingShingle | Chun-Yu Chen Mao-Jen Lin Wen-Chieh Yang Yu-Jun Chang Feng-Xia Gao Han-Ping Wu Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department Journal of Microbiology, Immunology and Infection |
| title | Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department |
| title_full | Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department |
| title_fullStr | Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department |
| title_full_unstemmed | Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department |
| title_short | Clinical spectrum of intra-abdominal abscesses in children admitted to the pediatric emergency department |
| title_sort | clinical spectrum of intra abdominal abscesses in children admitted to the pediatric emergency department |
| url | http://www.sciencedirect.com/science/article/pii/S168411821830286X |
| work_keys_str_mv | AT chunyuchen clinicalspectrumofintraabdominalabscessesinchildrenadmittedtothepediatricemergencydepartment AT maojenlin clinicalspectrumofintraabdominalabscessesinchildrenadmittedtothepediatricemergencydepartment AT wenchiehyang clinicalspectrumofintraabdominalabscessesinchildrenadmittedtothepediatricemergencydepartment AT yujunchang clinicalspectrumofintraabdominalabscessesinchildrenadmittedtothepediatricemergencydepartment AT fengxiagao clinicalspectrumofintraabdominalabscessesinchildrenadmittedtothepediatricemergencydepartment AT hanpingwu clinicalspectrumofintraabdominalabscessesinchildrenadmittedtothepediatricemergencydepartment |