Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report

Takano, Yuichi; Hayashi, Masafumi; Niiya, Fumitaka; Nakanishi, Tōru; Hanamura, Shotaro; Asonuma, Kunio; Yamamura, Eiichi; Gomi, Kunihide; Kuroki, Yuichiro; Maruoka, Naotaka; Inoue, Kazuaki; Nagahama, Masatsugu

doi:10.1186/s13104-017-2445-8

Cited by 16 publications

(17 citation statements)

References 11 publications

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“…[ 2 ] Various organisms, including anaerobic, gas-forming bacteria, and E coli , cause emphysematous infections in various organs. [ 10 – 12 ] However, emphysematous IE caused by E coli has only been reported in veterinary infections. [ 13 ] Although E coli is not a typical organism of IE, we failed to obtain a tissue specimen to confirm the diagnosis of IE due to refusal of surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Transthoracic and transesophageal sonography failed to detect the emphysema due to poor penetration of the air surrounding the valve. Reports from the ultrasonography described emphysematous infections arising from intra-abdominal infections; [ 12 , 15 ] however, the gold standard for diagnosis of emphysematous infections is CT. Therefore, we recommend that CT scans be used to diagnose intracardiac complications arising from E coli bacteremia.…”

Section: Discussionmentioning

confidence: 99%

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Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Kim

Yi²,

Kim³

et al. 2018

Medicine

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Rationale:Infective endocarditis (IE) is a life-threatening disease, mostly caused by gram-positive bacteria. Gram-negative bacteria were identified as a causative organism in relatively small number of cases. Although, antibiotic-resistant Escherichia coli is common cause of gram-negative endocarditis, AmpC beta-lactamase (BL)-harboring E coli is very rare cause of IE. Furthermore, emphysematous endocarditis is also a very rare manifestation of E coli infection.Patient concerns:We report a case of 80-year-old female patient presenting with dizziness, fever, and altered mental status, who was finally diagnosed with emphysematous endocarditis caused by E coli harboring an AmpC BL gene.Diagnosis:Her chest computed tomography revealed air bubbles surrounding the annulus of a mitral valve and a transesophageal echocardiogram revealed a hyperechogenic mass fixed on the posteromedial side of the mitral annulus with 2 eccentric mitral regurgitation jets. Blood cultures grew E coli which harbored the DHA-type AmpC BL. The organism belonged to a B2 phylogenic group, and multilocus sequence typing analyses revealed that the strains were of ST-95.Interventions:She was treated with meropenem following the resistant profiles, and surgery was recommended by the healthcare professional, but denied by the patient's guardians. She was transferred to another hospital due to a refusal for further treatment.Lessons:Emphysematous endocarditis is an uncommon complication of E coli bacteremia. Certain phylogenetic groups may be associated with development of E coli endocarditis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Kim

Yi²,

Kim³

et al. 2018

Medicine

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“…With regard to laboratory investigations (Table 3 [11][12] and Table 4 [8,[38][39][40][41][42][43][44][45][46][47]), patients with GFPLA-Cp had higher levels of aspartate aminotransferase (AST) (869.20 ± 583.02 IU/L versus 233.12 ± 98.19 IU/L, P=0.007) and alanine aminotransferase (ALT) (609.00 ± 516.26 IU/L versus 199.85 ± 74.93 IU/L, P=0.034) than patients with GFPLA-Kp at hospital admission. However, no statistically significant differences were found in alkaline phosphatase levels between the 2 patient groups.…”

Section: Resultsmentioning

confidence: 99%

“…Statistical differences were considered significant at a P value ˂0.05. Table 1 [11][12] and Table 2 [8,[38][39][40][41][42][43][44][45][46][47] show the clinical characteristics and laboratory test results of patients with GFPLA-Kp (12 cases) and patients with GFPLA-Cp (24 cases). The mean ages of patients with GFPLA-Kp and patients with GFPLA-Cp were 67.08 ± 10.22 years and 66.70 ± 8.78 years, respectively.…”

mentioning

confidence: 99%

Characteristics of gas-forming pyogenic liver abscess caused by Klebsiella pneumoniae and Clostridi perfringens

Chen¹,

Jiang²,

Guo³

et al. 2019

Preprint

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Background: Gas-forming pyogenic liver abscess is a life-threatening disease with poor prognosis commonly caused by 2 bacteria, Klebsiella pneumoniae and Clostridium perfringens . Due to its low incidence and associated high mortality rate, it is important to study the biological characteristics of the disease. The aim of this study was to conduct a worldwide review of literature on gas-forming pyogenic liver abscess caused by K. pneumoniae and C. perfringens . Methods: We searched PubMed and Web of Science databases from January 2009 to March 2019, with published in English. All relevant articles were accessed in full text. The manual search included references of retrieved articles. Finally, 35 publications were selected for review. Results: The results showed that more cases of gas-forming pyogenic liver abscess in Asia were caused by K. pneumoniae than by C. perfringens (P=0.011). The prevalence of diabetes mellitus in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae was higher than caused by C. perfringens (P=0.032). The survival rate of patients with gas-forming pyogenic liver abscess caused by K. pneumoniae who received surgical debridement or drainage was higher than caused by C. perfringens (P=0.002). Conclusions: The prevalence of diabetes mellitus was higher in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae than in patients caused by C. perfringens .

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“…In addition to the application of effective antibiotics and good control of blood sugar, performing percutaneous abscess drainage, especially for patients with abscess diameters of >5 cm, is necessary for certain cases. Emergency surgery is considered if abscess rupture and peritonitis occur [23].…”

Section: Emphysema Infectionmentioning

confidence: 99%

Progress in clinical research complicated infection with diabetes mellitus

Han

Wang

Chen

et al. 2018

Infection International

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Patients with diabetes are prone to concurrent infection. The mechanism of concurrent infection is related to factors such as hyperglycemia and weakened defense function. The infections of patients with diabetes include general and special infections. General infection includes infections in the respiratory system, urinary system, hepatobiliary system, and skin mucosa. Meanwhile, special infection includes invasive otitis externa, nasal mucormycosis, necrotizing fasciitis, and emphysema infection. Patients with special infections also have a higher mortality rate than those with general ones. Complicated infection with diabetes is difficult to treat and has poor prognosis. Therefore, a patient requires active treatment once infected with this infection.With the increased prevalence of diabetes, related acute and chronic metabolic disorders and various complications, such as complications in the blood vessels and nerves, also increase significantly, thereby posing the challenges for the overall survival of patients with diabetes. Patients with diabetes suffer from T-lymphocyte and neutrophil dysfunction, decreased humoral immune function, oxidative-antioxidative imbalance, and defects in opsonization and phagocytosis [1]. Patients with diabetes are significantly prone to infection, which is difficult to control. Many specific infections are common in patients with diabetes, whereas some infections occur almost exclusively in patients with diabetes. This article reviews the progress in clinical research on complicated infection with diabetes.

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Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report

Cited by 16 publications

References 11 publications

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Characteristics of gas-forming pyogenic liver abscess caused by Klebsiella pneumoniae and Clostridi perfringens

Progress in clinical research complicated infection with diabetes mellitus

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