Invasive Klebsiella pneumoniae liver abscess syndrome

Liu, Chung Hsien; Tsai, Ming-Jen

doi:10.1016/j.tcmj.2015.11.001

Cited by 2 publications

(5 citation statements)

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“…When this occurs during bacterial translocation, pathogens can circulate to the liver through the portal vein, causing liver abscesses. After the gastrointestinal colonization by K. pneumoniae through environmental exposure or the fecal-to-oral transmission, the bacteria may cross the intestinal barrier to invade the liver (32). Asian populations may be predisposed to intestinal colonization by highly toxic K. pneumoniae strains, a fact that may explain the high prevalence of K. pneumoniae in patients with PLA in Asia.…”

Section: Discussionmentioning

confidence: 99%

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

Nie

Lin²,

Li³

2023

Front. Surg.

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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.

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Section: Discussionmentioning

confidence: 99%

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

Nie

Lin²,

Li³

2023

Front. Surg.

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“…[2][3] Risk factors for developing liver abscess include diabetes, male sex, middle age, and Asian descent. [4][5][6] Common clinical manifestations include fever, chills, and abdominal pain. [2][3][5][6] Laboratory investigations usually demonstrate elevated liver enzymes, elevated C-reactive protein, leukocytosis, and thrombocytopenia.…”

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confidence: 99%

“…[4][5][6] Common clinical manifestations include fever, chills, and abdominal pain. [2][3][5][6] Laboratory investigations usually demonstrate elevated liver enzymes, elevated C-reactive protein, leukocytosis, and thrombocytopenia. [2][3][5][6] The mainstay of treatment is with appropriate parenteral and subsequent oral antibiotics.…”

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confidence: 99%

“…[2][3][5][6] Laboratory investigations usually demonstrate elevated liver enzymes, elevated C-reactive protein, leukocytosis, and thrombocytopenia. [2][3][5][6] The mainstay of treatment is with appropriate parenteral and subsequent oral antibiotics. However, percutaneous aspiration and even surgical intervention may be required for larger abscesses > 5 cm.…”

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confidence: 99%

“…However, percutaneous aspiration and even surgical intervention may be required for larger abscesses > 5 cm. [6][7][8] POCUS can rapidly identify the source of sepsis and lead to both an earlier diagnosis and definitive intervention compared with a standard clinical assessment. 8 For patients with right upper quadrant pain, the literature demonstrates that emergency physicians can be trained to assess gallbladder pathology like cholecystitis with a high degree of accuracy.…”

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confidence: 99%

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Unexpected source of fever: Liver abscess on point-of-care ultrasound

Iradukunda

Kim

2018

CJEM

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A previously healthy 58-year-old male presented to the emergency department with a 1-week history of fever and abdominal pain. Initial laboratory investigations demonstrated an elevated white blood cell count and transaminasemia. Point-of-care ultrasound (POCUS) was performed to assess for gallbladder pathology; it unexpectedly identified a 7 cm × 6 cm × 6 cm heterogeneous mass within the liver (Figure 1, Supplementary Video 1). A subsequent computed tomography scan suggested the mass to be a liver abscess (Figure 2A and 2B). It was later percutaneously aspirated under ultrasound guidance and grew Klebsiella pneumoniae. The patient was successfully treated with a 6-week course of intravenous ceftriaxone. Liver abscesses appear primarily hypoechoic with some internal echoes on ultrasound. However, they may also be hyperechoic or have a solid appearance resembling a hepatic tumor. 1

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Invasive Klebsiella pneumoniae liver abscess syndrome

Cited by 2 publications

References 5 publications

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

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

Unexpected source of fever: Liver abscess on point-of-care ultrasound

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