Clinical and microbiological characteristics of pyogenic liver abscess in a tertiary hospital in East China

Kong, Haishen; Yu, Fei; Zhang, Weili; Li, Xuefen

doi:10.1097/md.0000000000008050

Cited by 48 publications

(71 citation statements)

References 17 publications

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“… 1 , 22 , 23 In the present study, most cases of PLA were considered to be cryptogenic, while biliary disease was the most common identifiable cause of PLA in non-cryptogenic cases. The findings related to infectious origin were in accordance with those reported in two recent large case reports in China, 5 , 13 , 24 and changes to the infectious origin of PLA are likely to be the result of improvements in antibiotics and treatment modalities.…”

Section: Discussionsupporting

confidence: 90%

Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

et al. 2018

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ObjectiveTo enhance theoretical support of pyogenic liver abscess (PLA) treatment by comparing characteristics of patients with either PLA with an identified infectious origin (non-cryptogenic) or PLA with no obvious underlying cause (cryptogenic).MethodsThis retrospective study included all first episodes of PLA in adults admitted to a tertiary hospital between 2009 and 2016. Relevant clinical data were collected for patients with cryptogenic or non-cryptogenic PLA and compared across a number of characteristics.ResultsIn all, 178 patients were included: 111 cases (62.4%) of cryptogenic PLA, and 67 cases (37.6%) of non-cryptogenic PLA. Diabetes mellitus was significantly more prevalent in patients with cryptogenic PLA than those with non-cryptogenic PLA. The proportion of multidrug resistance/poly-microbial infection was significantly lower and Klebsiella pneumoniae infection was significantly higher in the cryptogenic versus non-cryptogenic PLA group. Metastatic infection occurred in four patients with cryptogenic PLA only, and all had diabetes and K. pneumoniae infection. Multivariate logistic regression analysis revealed that male sex, diabetes and K. pneumoniae were independent predictors for cryptogenic PLA.ConclusionsCryptogenic and non-cryptogenic PLA have distinctly different characteristics, suggesting a potential need for different treatment approaches.

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Section: Discussionsupporting

confidence: 90%

Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

et al. 2018

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“…Thirty three percent and all of them were surgically drained, respectively [32,33]. They also alerted that about 10 % of the patients with Klebsiella pneumoniae-associated PLA had invasive liver abscess syndrome with distant metastasis infection, as compared to only one (0.2 %) of our cohort [16].…”

Section: Discussionmentioning

confidence: 55%

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Morii¹,

Yamamoto²,

Nakamura³

et al. 2017

GHOA

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Background: Percutaneous catheter drainage (PCD) is currently the preferred therapeutic procedure of pyogenic liver abscesses (PLAs). However, multilocular poorly liquefied PLAs (MPLPs) are unsuitable for PCD. As reports on MPLPs are scarce, we aimed to explore possible therapeutic strategies for this serious type of PLA. Methods:The medical records of patients with PLA who were hospitalized at our institution between January 2011 to December 2015 were retrospectively reviewed. Demographic factors, biochemical, bacteriological, and imaging results, and treatment outcomes were evaluated.Results: Fourteen patients with MPLPs and 37 with drainable PLAs were identified and included in the study. Clinical characteristics were generally similar between the two groups. Klebsiella pneumoniae accounted for the majority of the culprit pathogens in MPLPs. Patients with MPLPs were managed medically without PCD. Despite this, treatment outcomes were not inferior compared to patients with drainable PLAs. Contrast-enhanced images revealed that the intricate septa of the MPLP maintained its blood perfusion. Most MPLPs did not liquefy over the treatment period. Conclusion:We should remember that MPLP is not rare. The septa may have delivered antibiotics adequately into the MPLPs, thus producing good treatment outcomes. Despite our findings, a high level of suspicion of treatment failure is crucial in these patients to ensure favorable treatment outcomes.

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“…Worldwide frequency of pyogenic liver abscess is around 1.1-2.3 per 100,000 person-years. 15 While in China the incidence rate of 5.7 per 100,000 populations. 16 In this study, 65(89%) of males were affected with liver abscess.…”

Section: Discussionmentioning

confidence: 99%

Liver abscess: demographic, clinical, biochemical, imaging and microbial spectrum

et al. 2019

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Background: Liver abscesses are localized suppurative destruction of liver tissue due to infections of either bacterial (Pyogenic) or protozoa (Amoebic). Historically; pyogenic liver abscess has been described since the time of hippocrates (400 BC). Despite the more aggressive approach to treatment, the mortality rate remained at 60-80%.Methods: This Cross-sectional analytical study carried out at Department of Medicine, Al-Tibri Medical College Hospital, Karachi, from June 2017 to December 2018. All participants of either gender with diagnosis of liver abscess were included in this prospective study. Patients with co morbidities like malignancy, autoimmune disease or on immunosuppressive treatment for any reason were excluded from the study. Following confirmation of the diagnosis; different characteristics of either type of liver abscess like demographic, clinical features, biochemical and imaging findings were evaluated.Results: Data of 73 subjects, 65(89.0%) males and 08(11.0%) females were analyzed with mean age was 45.42±14.518 years. Fifty-four (73.97%) patients had pyogenic liver abscess while amoebic liver abscess was found in 19(26.03%) subjects. Clinically, the most common symptom was abdominal pain, found in 66(90.4%) subjects, followed by fever in 61(83.6%), hepatomegaly in 47(64.4%), jaundice in 18(24.7%) and vomiting in 10(13.7%) cases. Demographics and clinical features are shown in (Table 1).Conclusions: Local trends have been changing and majority of liver abscess were of pyogenic liver abscesses. Clinically, clear differentiation between two types of abscesses is not possible always but few manifestations like typical symptoms, raised alkaline phosphatase and leucocytosis may be helpful.

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Clinical and microbiological characteristics of pyogenic liver abscess in a tertiary hospital in East China

Cited by 48 publications

References 17 publications

Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Liver abscess: demographic, clinical, biochemical, imaging and microbial spectrum

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