Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Czerwonko, Matías E.; Huespe, Pablo; Bertone, Santiago; Pellegrini, Pablo Ariel; Mazza, Oscar; Pekolj, Juan; Santibañés, Eduardo de; Hyon, Sung Ho; Santibañes, Martín de

doi:10.1016/j.hpb.2016.09.001

Cited by 41 publications

(55 citation statements)

References 31 publications

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“…In our cohort, 50 % of MPLPs were larger than 5 cm in diameter and 29 % were multiple. Despite these unfavorable factors, the overall fatality rate in our cohort was 4%, which was equal to or better than rates reported in previous studies about PLAs (Table 2) [1,2,22,23,28]. Fatality rates did not differ between MPLP and drainable PLA groups in our cohort.…”

Section: Discussionsupporting

confidence: 54%

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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Section: Discussionsupporting

confidence: 54%

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

Morii¹,

Yamamoto²,

Nakamura³

et al. 2017

GHOA

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“…4,5,74,81,112 and of MDR bacterial infections between 31 and 68%. 4,5,81,111,112 In contrast, the data with large sample from Southeast Asia indicate that the most common pathogen in patients with PLA of nonbiliary origin is K. pneumonia, with high positive culture rate reaching to 64 and 71%, respectively, 4,32 while E. coli is uncommon being only 5 and 4%, respectively. 4,32 And, the incidences of polymicrobial infections and MDR isolates in our large sample analysis on 444 patients with PLA of nonbiliary origin are 9 and 7%, respectively.…”

Section: Main Features Of Pathogensmentioning

confidence: 92%

“…Pyogenic liver abscess of biliary origin is more likely caused by E. coli, more often presented as polymicrobial infections, and more associated with MDR bacteria. At present, the incidence of E. coli serving as one pathogen in patients with PLA of biliary origin ranges from 21 to 36%, 4,32,74,111,112 and then K. pneumonia from 9 to 31%, 4,32,74,111,112 with the occurrence rate of polymicrobial infections fluctuating between 40 and 68% Fig. 4 Pyogenic liver abscess (PLA) occurred in patients' hepatopancreatobiliary tumor treated by one part of operations with a hepaticojejunostomy (A, B) or indwelling biliary stent (C).…”

Section: Main Features Of Pathogensmentioning

confidence: 99%

Pyogenic Liver Abscess of Biliary Origin: The Existing Problems and Their Strategies

2018

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Pyogenic liver abscess (PLA) of biliary origin in Southeast Asia mainly occurs in patients with intrahepatic bile duct stone (IBDS) and extrahepatic bile duct stone (EBDS), bilioenteric anastomosis, or biliary stent. IBDS, as an endemic to Southeast Asia, remains a frequent etiology of acute cholangitis and PLA. PLA related to IBDS is characterized by high incidences of PLA recurrence and death related to infection, and difficulties in diagnosis of concomitant cholangicarcinoma. PLA of biliary origin is more likely caused by more often presented as polymicrobial infections, and more associated with extended-spectrum β-lactamase (ESBL)-producing isolates. In this review, the authors summarize the differences on the presumed causes, pathogens, multidrug resistance, treatment, and prognosis of PLA between biliary origin and cryptogenic origin, the latter serving as a first and foremost presumed etiology of PLA. The authors also discuss the existing problems on early diagnosis of concomitant cholangicarcinoma related to IBDS.

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“…The mortality ranged from 6Á9% to 9Á1%, depending on the populations studied [7][8][9]. The mortality ranged from 6Á9% to 9Á1%, depending on the populations studied [7][8][9].…”

Section: Original Articlementioning

confidence: 96%

“…Pyogenic liver abscess remains a critical problem clinically due to its severe mortality. The mortality ranged from 6Á9% to 9Á1%, depending on the populations studied [7][8][9]. To date, many factors have been found to be associated with increased risk of pyogenic liver abscess, including chronic kidney disease on dialysis therapy, splenectomy, appendectomy, herpes zoster and zolpidem use [5,[10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: a population-based cohort study

2017

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Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Abstract: Background: In times of modern surgery, transplantation and percutaneous techniques, pyogenic liver

Cited by 41 publications

References 31 publications

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

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

Pyogenic Liver Abscess of Biliary Origin: The Existing Problems and Their Strategies

Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: a population-based cohort study

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