A complex presentation of an uncommon disease: Gas-forming pyogenic liver abscess complicated by septic pulmonary emboli and muscle abscesses, a case report and review of the literature

Gas Formation in Pyogenic Liver Abscess Is Independently Correlated with Diabetes Mellitus but not with Pathogenic Bacteria

“…The results demonstrated that patients with GFPLA had worse liver function, more severe in ammatory responses, and a higher in-hospital mortality rate than patients with non-GFPLA, in line with previous studies indicating that GFPLA has more severe clinical characteristics [6, 8, [22][23][24]. Investigations of risk factors associated with GFPLA can help clarify the underlying pathological mechanisms of the greater disease severity in patients with GFPLA.…”

“…Meanwhile, Lee et al reported that the gas composition in the pus cavity is the same as the partial gas composition in the human gastrointestinal cavity [25][26][27][28]. To eliminate the in uence of biliary abnormality, we conducted the Step 2 analysis after excluding patients with a history of biliary abnormality, and DM remained an independent risk factor for GFPLA, in line with previous studies reporting the close relationship between GFPLA and DM [6, 22,24,29]. Lee et al hypothesized that gas formation in PLA is linked to increased gas production, impaired gas transportation, and an impaired equilibrium between gas in local tissues and that in abscesses [28], and all of these conditions can be effectively created by DM.…”