Solitary liver abscess: a continuing medicosurgical problem.

The management problems of 22 patients with solitary liver abscess are reviewed. To achieve earlier diagnosis, and reduce the high mortality rate of this condition (32% in this series), clinicians need to change their data base of the clinical presentation and also to incorporate liver imaging as part of the routine investigation of a patient with pyrexia of uncertain origin. The problems associated with operative diagnosis, and with methods of surgical drainage are discussed. The need for careful bacteriological cultures is emphasized, and the use of the most appropriate antibiotics is described. While in many cases the cause of the liver abscess remains unknown, in Australia the possibility of the abscess being amoebic or an infected hydatid cyst should be kept in mind.