The Incidence of Septic Pulmonary Embolism in Patients with Klebsiella pneumoniae Liver Abscess: A Systematic Review and Meta-analysis

Abstract

Background: Septic pulmonary embolism (SPE) is an associated complication of Klebsiella pneumoniae liver abscess (KPLA). However, previous studies have reported that its incidence varies widely. We conducted a systematic review and meta-analysis to investigate the incidence of SPE in patients with KPLA. We further analyzed their clinical and computed tomography (CT) features. Methods: Two researchers reviewed PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify the articles that reported SPE in patients with KPLA. The search was conducted from the date of establishment of each database up to January 2021. After screening the articles and extracting the data, we used Review Manager 5.3 for analysis and processing. Results: We selected six articles that included 1,158 patients with KPLA. Of these, 70 patients had SPE. The pooled incidence of SPE was 6% (95% confidence interval, 3%–9%). Among patients with SPE, 85% were men, 72% had diabetes, and 52% displayed the feeding vessel sign on the chest CT. The mortality rate was 12%. Quality assessment revealed that half of the included studies had a high quality. Conclusion: The pooled incidence of SPE in patients with KPLA was 6%. Men and patients with diabetes were more prone to SPE. For patients with KPLA who had SPE as an associated complication, the mortality rate was approximately 12%.

Alterations of Gut Microbiota in Pyogenic Liver Abscess Patients with and without Type 2 Diabetes Mellitus

“… 24 Furthermore, individuals with liver abscess were found to be susceptible to hepatic venous thrombophlebitis, 25 which can lead to cerebral venous thrombosis 26 and pulmonary embolism. 27 The resolution of venous thrombosis is closely linked to the resolution of PLA. 28 The mechanism by which DM contributes to higher blood coagulation indexes in PLA patients requires further study.…”

Clinical Spectrum and Outcomes of Cryptogenic Klebsiella pneumoniae Liver Abscess in the Americas: A Scoping Review

“…Although diabetes has been associated with metastatic complications in other studies, it was not found to be a risk factor for metastatic infection in that cohort [ 40 ]. Other reports have described Southeast/East Asian origin, male gender, symptomatic disease (dyspnea or sepsis), and abscess size as predictors for metastatic complications [ 30 , 40 , 41 , 42 ].…”