Clinical presentation of pyogenic liver abscess in the elderly.

The presenting features of seven elderly patients with pyogenic liver abscess were reviewed retrospectively. Symptoms of malaise, anorexia and abdominal pain referrable to intra-abdominal pathology were present in only 43% cases and physical examination was frequently unhelpful. Leucocytosis, hyperbilirubinaemia and raised alkaline phosphatase were of diagnostic value in the majority of patients. Chest and urinary tract infections were frequent predisposing conditions. Antibiotic therapy for four weeks is adequate in elderly patients if combined with drainage procedures.