scholarly journals A nationwide study of the incidence and 30-day mortality rate of pyogenic liver abscess in Denmark, 1977-2002

2005 ◽  
Vol 21 (10) ◽  
pp. 1185-1188 ◽  
Author(s):  
P. Jepsen ◽  
H. Vilstrup ◽  
H. C. Schonheyder ◽  
H. T. Sorensen
2021 ◽  
Author(s):  
Yiming Liu ◽  
Yanqiao Ren ◽  
Jun Chen ◽  
Songlin Song ◽  
Chuansheng Zheng

Abstract Background: The purpose of this study was to evaluate the clinical, laboratory and microbiological features, clinical outcomes, and prognosis of pyogenic liver abscess (PLA) in non-liver cancer (Non-LC) patients and liver cancer patients treated with transarterial chemoembolization (TACE, LC-TACE).Methods: Clinical data of 48 consecutive PLA patients from January 2016 to December 2020 were retrospectively analyzed. The mortality was compared between the two groups of PLA patients, and risk factors for mortality were evaluated.Results: A total of 48 PLA patients meeting the inclusion criteria were included in this study from January 2016 to December 2020, including 31 males and 17 females. Among them, there were 32 patients in the Non-LC group and 16 patients in the LC-TACE group. Fever and chills were the most common symptoms in both groups, followed by abdominal pain. Shock occurred in 2 patient in the Non-LC group and 3 patients in the LC-TACE group. The positive rate of pus culture in the Non-LC group was 87.5%, among which the most common pathogen was Klebsiella pneumoniae (50%, 14/28), and the positive rate of pus culture in the LC-TACE group was 81.3%, among which the most common pathogen was Escherichia coli (30.8%, 4/13). In the Non-LC group, 28 patients improved after treatment, 1 patient did not improve, and 3 patients died during hospitalization, with a mortality rate of 9.4%. In the LC-TACE group, 9 cases improved after treatment, 3 cases did not improve, and 4 cases died during hospitalization, with a mortality rate of 25%. Multivariate analysis revealed no independent prognostic factor associated with mortality. The cure time of the Non-LC group was 37.4±23.1 days (6-90 days), while that of the LC-TACE group was 91.5±49.7 days (19-180 days), with a statistically significant difference between the two groups (P < 0.001).Conclusions: PLA of the Non-LC group and the LC-TACE group were different in terms of pathogenic bacteria and cure time, etc. For PLA after TACE, a more aggressive and comprehensive treatment should be considered.


2018 ◽  
Vol 1 (3) ◽  
pp. 26-27
Author(s):  
Karjpong Techathuvanan

Gas-forming pyogenic liver abscess (GFPLA) is uncommon and reported high mortality rate. Diabetes mellitus and Klebsiella pneumoniae are the most frequent associated conditions and causativeorganism. Gas collection is not often detected by plain film abdomen. On ultrasonography, gas appeared as hyperechoic foci with dirty shadowing, reverberation and ring-down artifacts. CT scan is the mostsensitive test for GFPLA. Early diagnosis, appropriate antibiotics, adequate drainage and plasma glucose control are essential management. Figure 1  Plain film abdomen พบ multiple round and oval hypodensity gas pockets with air-fluid levels at right subphrenic region


Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuangjun He ◽  
Jie Yu ◽  
Hairong Wang ◽  
Lifeng Wang ◽  
Yi Chen ◽  
...  

Abstract Background Highly empiric use of carbapenem in pyogenic liver abscess (PLA) is widespread problem. However, few studies have examined the association between blood culture and carbapenem use in patients with PLA in China. Thus, we conducted this observational study. Methods The data of patients diagnosed with PLA at two comprehensive tertiary care centers from 2014 to 2020 were retrospectively collected. Demographic and clinical data were analyzed, and univariate and multivariate analyses were performed to investigate the association between blood culture and carbapenem use. Subgroup analysis was conducted to explore whether the effect is different in sepsis. Results Blood culture was performed in 110 (46.0%) patients, of whom 44 (40.0%) patients had positive results for bacterial culture. Extended-spectrum beta-lactamase (ESBL)-positive blood culture isolates were detected in 8 (7.3%) patients. The positivity rate of blood culture in sepsis was higher than in non-sepsis (58.1% vs. 32.9%, P = 0.015). Fewer patients who had a blood culture received carbapenem treatment in comparison to patients without blood culture (19.1% vs. 31.8%, P = 0.026). Multivariate analysis showed that blood culture was independently associated with less carbapenem exposure (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.16–0.68, P = 0.003), and this effect remained significant in the sepsis subgroup (adjusted OR = 0.17, 95% CI: 0.05–0.53, P = 0.002). Conclusion Blood culture had a high positivity rate and was associated with less carbapenem use in PLA, especially those who developed sepsis. More attention should be paid to performing early blood culture and less carbapenem use in PLA.


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