Clinical characteristics and management of 106 patients with pyogenic liver abscess in a traditional Chinese hospital

Abstract

This is a retrospective study of clinical data from 106 patients with pyogenic liver abscess (PLA) treated in a traditional Chinese hospital during the eight years preceding this publication. We aimed to provide evidence to improve the diagnosis accuracy and the treatment strategies for PLAs. We collected records of patients treated at the Guangxing Hospital, which is affiliated to the Zhejiang Traditional Chinese University in Hangzhou, and we collected their general background information, laboratory and imaging features, and clinical manifestations and outcomes to perform a retrospective analysis. Diabetes mellitus (45.3%, 48/106), biliary calculi (36.8%, 39/106), and history of abdominal surgery (15.1%, 16/106) were the three most common PLA risk factors present in our cohort. Fever and chills (95.3%, 101/106), right upper quadrant pain/epigastric discomfort (68.9%, 73/106), nausea and vomiting (38.8%, 41/106), and cough and sputum (14.2%, 15/106) were the most common clinical manifestations of PLA. Most patients had the abscesses in the right liver lobe, and the most commonly found bacteria were Klebsiella pneumoniae (54.8%, 42/76), Escherichia coli (35.1%, 27/76), and Streptococcus pneumoniae (3.9%, 3/76). Liver Doppler ultrasound is a conventional and effective method to identify liver abscesses. Most patients were treated using a percutaneous puncture under B-ultrasound guidance. Most patients (n = 104 or 98.1%) were cured, one patient (0.9%) died, and one was discharged with multiple abscesses post treatment.

Clinical characteristics, diagnosis, treatment, and outcome of patients with liver abscess due to Aspergillus spp: a systematic review of published cases

“…Older age is considered a risk factor for BLA but not for ILA. In our review, the mean age was 38 years which is much younger than 65 years as reported in previous studies on BLA, yet similar to the mean age of patients with ALA of 41 years [2,4,5,38]. The reason why ILA is a disease of a younger population is probably related to the predispostion of lymphoma and leukemia for this popluation, and organ transplant recipients tend to be younger.…”

“…Similar to BLA and ALA, ILA occurred more frequently in men. It remains unclear why liver abscesses are more common in men, but across the studies that seems to be a consistent finding regardless of the etiology of liver abscess [2,4,5]. In patients with ALA, this noticeable discrepancy could be explained by several mechanisms, including the effect of testosterone, and by alcohol consumption which is traditionally more prominent in men.…”

“…A liver abscess (LA) is a rare condition characterized by the formation of a purulent cavity by microorganisms in the liver [1][2][3][4][5]. LA is classified as bacterial, protozoan (amoebic), or fungal [1][2][3][4][5].…”

“…A liver abscess (LA) is a rare condition characterized by the formation of a purulent cavity by microorganisms in the liver [1][2][3][4][5]. LA is classified as bacterial, protozoan (amoebic), or fungal [1][2][3][4][5]. The most common causes of bacterial (pyogenic) liver abscesses (BLA) are Escherichia coli, Klebsiella spp, Streptococcus anginosus group, Staphylococcus aureus, and anaerobes.…”

“…Amebic liver abscesses (ALA) are the most common manifestation of extraintestinal amebiasis caused by Entamoeba histolytica. Fungal pathogens, however, are comparitively rare cause of LA [1][2][3][4][5].…”