Clinical features of eosinophilic liver abscess

Abstract

Backgroud: Eosinphilic liver abscess is often encountered in clinical practice. Imaging findings of eosinophilic liver abscess are well characterized but its clinical features are totally unknown. Methods: Medical records of Seoul National University Hospital in Seoul, Korea, from July 2004 to February 2008, were retrospectively reviewed. Eosinophilic liver abscess was defined by typical radiologic findings on computed tomography (CT) plus peripheral eosinophilia (>500 ll). Results: The incidence rate was 0.7% (257 cases/36 438 subject who underwent CT) and medical records of 229 cases (male; 75.5%) were analyzed. Among them, 76.8% of cases were found by chance (routine check or CT for other purposes) and thus they were asymptomatic. The others complained of non-specific symptoms, such as vague abdominal pain, nausea, loose stool, and dyspepsia. Presumptive causes were unidentified (70.3%), malignancyassociated (17.1%), parasite-associated (10.4%) and hypereosinophilic syndrome (2.2%) in decreasing order. At the end of observation periods, 63.4% of cases without identified causes showed spontaneous resolutions [mean time (range) from detection to resolution; 7.0 (0.3–53.0) months] and the rests showed no progress. Among cases without identified causes, 32.3% were treated by empirical anti-parasitic drugs which showed no difference in resolution rates (75.3% versus 71.2%, P > 0.05) but showed significantly reduced mean resolution times (10.8 versus 4.8 months, P = 0.018). Conclusions: Eosinophilic liver abscess without an obvious cause shows a benign clinical course. Empirical anti-parasitic treatment may shorten the duration of eosinophilic liver abscess.