scholarly journals Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

2018 ◽  
Vol 46 (9) ◽  
pp. 3824-3836 ◽  
Author(s):  
Jing Chen ◽  
Minwei Zhang ◽  
Jinlong Chen ◽  
Yaogui Ning ◽  
Xiaoyang Cai ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Multivariate Logistic Regression Analysis ◽  
Pyogenic Liver Abscess ◽  
Tertiary Hospital ◽  
Microbial Infection ◽  
Theoretical Support ◽  
Metastatic Infection ◽  
Infectious Origin ◽  
Male Sex ◽  
Different Characteristics

Objective To enhance theoretical support of pyogenic liver abscess (PLA) treatment by comparing characteristics of patients with either PLA with an identified infectious origin (non-cryptogenic) or PLA with no obvious underlying cause (cryptogenic). Methods This retrospective study included all first episodes of PLA in adults admitted to a tertiary hospital between 2009 and 2016. Relevant clinical data were collected for patients with cryptogenic or non-cryptogenic PLA and compared across a number of characteristics. Results In all, 178 patients were included: 111 cases (62.4%) of cryptogenic PLA, and 67 cases (37.6%) of non-cryptogenic PLA. Diabetes mellitus was significantly more prevalent in patients with cryptogenic PLA than those with non-cryptogenic PLA. The proportion of multidrug resistance/poly-microbial infection was significantly lower and Klebsiella pneumoniae infection was significantly higher in the cryptogenic versus non-cryptogenic PLA group. Metastatic infection occurred in four patients with cryptogenic PLA only, and all had diabetes and K. pneumoniae infection. Multivariate logistic regression analysis revealed that male sex, diabetes and K. pneumoniae were independent predictors for cryptogenic PLA. Conclusions Cryptogenic and non-cryptogenic PLA have distinctly different characteristics, suggesting a potential need for different treatment approaches.

scholarly journals Genomic Heterogeneity inKlebsiella pneumoniaeStrains Is Associated with Primary Pyogenic Liver Abscess and Metastatic Infection

2005 ◽  
Vol 192 (1) ◽  
pp. 117-128 ◽  
Author(s):  
Li‐Chen Ma ◽  
Chi‐Tai Fang ◽  
Cha‐Ze Lee ◽  
Chia‐Tung Shun ◽  
Jin‐Town Wang
Keyword(s):  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Metastatic Infection

scholarly journals Treatment of pyogenic liver abscess in a tertiary hospital in South Africa

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S405
Author(s):  
O. Chihaka ◽  
M. Bernon ◽  
U. Kotze ◽  
C. Kloppers ◽  
S. Burmeister ◽  
...  
Keyword(s):  
South Africa ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Tertiary Hospital

scholarly journals Independent prediction of aspartate aminotransferase to alanine aminotransferase ratio for adverse outcomes of patients with pyogenic liver abscess

2021 ◽  
Author(s):  
Huifang Dai ◽  
Youjin Pan ◽  
Jing Xu
Keyword(s):  
Liver Abscess ◽  
Roc Curve ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Univariate Analysis ◽  
Pyogenic Liver Abscess ◽  
Adverse Outcomes ◽  
Cutoff Value ◽  
Metastatic Infection ◽  
The Relationship

Abstract Background: In viral hepatitis, an increase in the ratio of aspartate aminotransferase to alanine aminotransferase (AAR) is associated with poor prognosis. However, the relationship between AAR and pyogenic liver abscess (PLA) remains to be unclear. In this study, the relationship between AAR and adverse outcomes in PLA patients were explored, and the predictive value of AAR were evaluated. Methods: In total, 240 PLA patients were consecutively enrolled in this study and followed up at 3 months. Univariate analysis, receiver-operating characteristic (ROC) curve analysis and multivariate logistic regression analyses were performed. Results: According to the ROC curve of AAR for adverse outcomes, the patients were divided into two groups using a cutoff of 0.97. Patients with high AAR had higher risk of mortality rate (16.5% vs 2.9%), empyema (23.7% vs 10.4%), metastatic infection (19.1% vs 9.7%), acute myocardial (7.3% vs 0.7%), acute hepatic failure (7.3% vs 2.2%) and septic shock (13.7% vs 4.4%) than patients with low AAR (all P<0.05). after adjusting for potential confounding factors in our logistic model, high AAR was independently associated with death (odds ratio (OR)=6.17, 95% of confidence interval (CI)=1.88-20.26) and all adverse outcomes (OR=4.03, 95% CI=2.12-7.66). AAR had the largest area under ROC curve (AUC) than ALT, AST in all adverse outcomes (AUC=0.690, cutoff value=0.97, P<0.01) and death prediction (AUC=0.821, cutoff value=1.31, P<0.01). Conclusion: In the clinical application of PLA, AAR may be a good method to predict the prognosis.

scholarly journals Characteristics of Pyogenic Liver Abscess

2021 ◽  
Author(s):  
Nenad Pandak ◽  
Asmaa S. Mahdi ◽  
Ali Al Majrafi ◽  
Mariya Molay ◽  
Stepen S. Deenadayalan ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Clinical Presentation ◽  
Anaerobic Bacteria ◽  
Pyogenic Liver Abscess ◽  
Tertiary Hospital ◽  
Empirical Treatment ◽  
Liver Malignancies ◽  
Intraabdominal Infections

Objectives: Liver abscess can develop as a complication of hepatobiliary disease or other intraabdominal infections, but more recently it is associated with primary and secondary liver malignancies and their treatment. The goal of this study was to analyze the epidemiology, etiology and clinical characteristics of pyogenic liver abscess in Oman. The intention was to obtain the information needed for the adequate liver abscess empirical treatment. Methods: This retrospective study took place in a tertiary hospital. Consecutive patients treated for the liver abscess during the five years period, from January 2013 until the end of 2017, were enrolled. Their demographic and clinical data were used to study the characteristics of pyogenic liver abscess in Oman. Results: Fifty-three patients with pyogenic liver abscess were enrolled in the study. They were predominantly male and younger than 60 years. Klebsiella pneumoniae was the most usual bacteria causing the liver abscess. Clinical presentation was unspecific and the abdominal pain and high fever were the most usual symptoms. Conclusion: The majority of pyogenic liver abscesses are caused by K. pneumoniae so the empirical treatment should be started with antibiotic directed against it. Further studies are needed to establish the local role of anaerobic bacteria in pyogenic liver abscess as well as to monitor the presence of hypervirulent K. pneumoniae in Oman. Keywords: Pyogenic liver abscess; Etiology; Epidemiology; Klebsiella pneumoniae.

scholarly journals The AST/ALT (De Ritis) Ratio Independently Predicts Adverse Outcomes in Patients with Pyogenic Liver Abscess

2020 ◽  
Author(s):  
Huifang Dai ◽  
Jing Xu
Keyword(s):  
Liver Abscess ◽  
Roc Curve ◽  
Univariate Analysis ◽  
Acute Hepatic Failure ◽  
Pyogenic Liver Abscess ◽  
Adverse Outcomes ◽  
Receiver Operating Curve ◽  
Cutoff Value ◽  
Metastatic Infection ◽  
Receiver Operating

Abstract Background: An elevated aspartate aminotransaminase to alanine aminotransaminase ratio (AST/ALT) displays relationships to poor prognosis in viral hepatitis. However, the association between AST/ALT and pyogenic liver abscess (PLA) is unclear.Aim:This study delved into the relationships of AST/ALT and unfavorable results of PLA cases and ascertained AST/ALT predicting significance.Methods: In total, 240 PLA cases were consecutively recruited here and underwent a 3-month following-up. This study carried out receiver-operating characteristic (ROC) curve study, multiple-variate logistic regression analyses and univariate analysis.Results: In line with the receiver-operating curve of AST/ALT for unfavorable results, the cases fell to two subgroups with the use of a threshold of 0.97. Cases with high AST/ALT had higher risk of mortality (16.5% vs 2.9%), metastatic infection (19.1% vs 9.7%), acute hepatic failure (7.3% vs 2.2%), acute myocardial (7.3% vs 0.7%), empyema (23.7% vs 10.4%) and septic shock (13.7% vs 4.4%) than cases with low AST/ALT (all P < 0.05). after adjusting for potential confounders in our logistic model, high AST/ALT was independently associated with all unfavorable results (OR = 4.03, 95% CI = 2.12–7.66) and death (odds ratio (OR) = 6.17, 95% of confidence interval (CI) = 1.88–20.26). AST/ALT exhibited the widest area underneath ROC curve (AUC) as compared with AST, ALT in death prediction (AUC = 0.821, cutoff value = 1.31, P < 0.01) and overall unfavorable results (AUC = 0.690, cutoff value = 0.97, P < 0.01).Conclusion: AST/ALT may be a good candidate for predicting prognosis in future clinical practice of PLA.

scholarly journals Endogenous Endophthalmitis and Liver Abscess: A Metastatic Infection or a Coincidence?

2021 ◽  
pp. 1-6
Author(s):  
Catarina Correia ◽  
Sandra Lopes ◽  
Sofia Mendes ◽  
Nuno Almeida ◽  
Pedro Figueiredo
Keyword(s):  
Liver Abscess ◽  
Signs And Symptoms ◽  
Pyogenic Liver Abscess ◽  
Endogenous Endophthalmitis ◽  
Metastatic Infection ◽  
Percutaneous Transhepatic Drainage ◽  
Severe Infections ◽  
Transhepatic Drainage ◽  
Systemic Antibiotics ◽  
Ocular Signs

<i>Klebsiella pneumoniae</i> is a gram-negative pathogen that is a common cause of severe infections, including pyogenic liver abscess. Dissemination of <i>K. pneumoniae</i> to other organs, including the eye, is associated with significant morbidity and mortality. In the particular case of endogenous endophthalmitis (EE) by <i>K. pneumoniae</i> the prognosis is poor. We report the case of a middle-aged female with <i>K. pneumoniae</i> liver abscess. The patient developed metastatic endophthalmitis that was aggressively treated with systemic antibiotics. The liver abscess resolved with antimicrobials and percutaneous transhepatic drainage, but regarding the endophthalmitis she was discharged from our hospital without recovery of her eyesight. Metastatic spread to the eye should be considered in all patients with liver abscesses who experience ocular signs and symptoms in order to establish a timely diagnosis of EE.

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