Giorgio A, Ciracì E, De Luca M, Stella G, Giorgio V. Hepatic abscess and hydatid liver cyst: European infectious disease point of view. World J Hepatol 2025; 17(2): 103325 [DOI: 10.4254/wjh.v17.i2.103325]
Corresponding Author of This Article
Antonio Giorgio, Professor, Department of Liver Unit, Athena Clinical Center, Via Matese, Piedimonte 81016, Caserta, Italy. antoniogiorgio@clinicathena.it
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Massimo De Luca, Liver Unit, Cardarelli Hospital, Naples 80131, Italy
Giuseppe Stella, Valentina Giorgio, Department of Pediatric and Women, Children and Public Health Sciences, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica Del Sacro Cuore, Rome 00168, Italy
Co-first authors: Antonio Giorgio and Emanuela Ciracì.
Author contributions: Giorgio A conceived the presented idea, performed the study; Ciracì E based on her knowledge of the clinical problem contributed to write the manuscript; Giorgio A and Ciracì E contributed equally to this article, they are the co-first authors of this manuscript; Giorgio A, De Luca M, Stella G, and Giorgio V wrote the manuscript; Ciracì E, De Luca M, Stella G, and Giorgio V contributed to bibliographical research; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Antonio Giorgio, Professor, Department of Liver Unit, Athena Clinical Center, Via Matese, Piedimonte 81016, Caserta, Italy. antoniogiorgio@clinicathena.it
Received: November 21, 2024 Revised: December 25, 2024 Accepted: January 21, 2025 Published online: February 27, 2025 Processing time: 96 Days and 15.9 Hours
Abstract
This manuscript is based on a recent study by Pillay et al that was published in recently. Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin. The incidence rate in Europe is lower than in developing countries, but it is a major complication with high morbidity, particularly in immunocompromised patients. They are most frequently caused by Enterobacterales infections, but hypervirulent Klebsiella strains are an emerging problem in Western countries. Amoebiasis has been a public health problem in Europe, primarily imported from other endemic foci. At the same time, this infection is becoming an emerging disease, as the number of infected patients who have not traveled to endemic areas is rising. Treatment options for hydatid liver cyst include chemotherapy, open or laparoscopic surgery, percutaneous treatment (percutaneous aspiration, re-aspiration and injection and its modification) and ‘‘wait and watch’’ strategy. Most hydatid liver cyst patients in Pillay et al’s study received surgical treatment, but several studies have confirmed the safety and efficacy of percutaneous aspiration, re-aspiration and injection.
Core Tip: Pyogenic and amoebic liver abscess represent a significant challenge in the diagnosis and treatment of focal bacterial and parasitic infectious hepatic disease, even in European countries. Ultrasound (US) is the first and main imaging tool involved in the diagnosis of these two rare and neglected diseases, respectively. US and US-guided percutaneous drainage of hepatic abscesses, either pyogenic or amoebic, play an essential role in their management. In hydatid liver cyst percutaneous puncture, injection of scolicidal agent with or without reaspiration has been shown to have higher efficacy, fewer complications and hospital stay compared to surgery.
