Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

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.

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Case of Pyogenic Liver Abscesses Caused by Klebsiella Pneumoniae

Journal of Gastroenterology & Digestive Systems ◽

10.33140/jgds/02/02/00001 ◽

2018 ◽

Vol 2 (2) ◽

Keyword(s):

Diabetes Mellitus ◽

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Anaerobic Bacteria ◽

Pyogenic Liver Abscess ◽

Hepatobiliary Disease ◽

Liver Abscesses ◽

Patients With Diabetes ◽

Aerobic And Anaerobic

Liver abscess is a serious intraabdominal infection can be due to result of bacteria, fungi, or parasites infection. Until the end of the last century, pyogenic liver abscesses were predominantly caused by mixed aerobic and anaerobic bacteria, the most frequent isolate being Escherichia coli [1]. Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Patients with diabetes mellitus and the preexisting hepatobiliary disease are particularly susceptible to infection as well as those from Southeast Asia [2]. We present a case of Klebsiella liver abscess with bacteremia.

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Case study of a sudden loss of vision in a diabetic patient: an unusual cause. Endogenous Klebsiella pneumoniae panophthalmitis and cerebellar abscess associated with pyogenic liver abscess

10.22541/au.161402688.83871227/v1 ◽

2021 ◽

Author(s):

Rohit Sharma ◽

Sundus Sardar ◽

Waail Rozi ◽

Ibrahim Sa'id Khamees ◽

Ibrahim Mohammad Obeidat ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Diabetic Patient ◽

Liver Abscess ◽

Vision Loss ◽

East Asian ◽

Pyogenic Liver Abscess ◽

Endogenous Endophthalmitis ◽

Newly Diagnosed ◽

Liver Abscesses ◽

Cerebellar Abscess

Background: Community-acquired pyogenic liver abscesses due to Klebsiella pneumoniae is increasingly recognized across the world with more incidence in East Asian countries. Cases of endogenous endophthalmitis secondary to pyogenic liver abscesses with K1 serotype K. pneumoniae have been reported in the literature. We report a case of endogenous panophthalmitis along with cerebellar abscess occurring in a newly diagnosed diabetic patient secondary to pyogenic liver abscess. Case presentation: A middle-aged male of east Asian descent presented with sudden onset right eye vision loss associated with fever. Workup revealed newly diagnosed diabetes mellitus, panophthalmitis, cerebellar abscess, and pyogenic liver abscess due to K. pneumoniae. The patient, unfortunately, underwent right eye evisceration. Conclusion: Endogenous panophthalmitis due to K. pneumoniae is a fatal complication and can result in blindness. Multiple foci of infection can be present in such cases. Thorough workup, prompt antibiotics as well as surgical treatment may improve prognosis.

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Klebsiella pneumoniae induced pyogenic liver abscess in critically ill patients: a retrospective study from a Chinese medical center, 1994-2015

10.26226/morressier.57c5383dd462b80296c9bad1 ◽

2016 ◽

Author(s):

Yun Qian

Keyword(s):

Retrospective Study ◽

Klebsiella Pneumoniae ◽

Critically Ill ◽

Liver Abscess ◽

Critically Ill Patients ◽

Medical Center ◽

Pyogenic Liver Abscess

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Pyogenic Liver Abscess in Normal Children With Fever of Unknown Origin

PEDIATRICS ◽

10.1542/peds.58.4.614 ◽

1976 ◽

Vol 58 (4) ◽

pp. 614-616 ◽

Cited By ~ 1

Author(s):

Sheldon L. Kaplan ◽

Ralph D. Feigin

Keyword(s):

Abdominal Pain ◽

Liver Abscess ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Pyogenic Liver Abscess ◽

Liver Function Tests ◽

Blood Cultures ◽

Normal Children ◽

The Past ◽

Liver Abscesses

Solitary pyogenic hepatic abscesses were identified as the cause of fever, abdominal pain, and hepatomegaly in two otherwise normal children who were seen at St. Louis Children's Hospital during the past year. Liver function tests were normal and blood cultures were negative in both patients. These cases illustrate that pyogenic liver abscess may occur in normal children and should be considered whenever fever of unknown origin is associated with abdominal complaints. Only in this way can we hope to improve upon the results cited previously, namely that the majority of liver abscesses remain undiagnosed during life.

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Effects of iron on the growth, biofilm formation and virulence of Klebsiella pneumoniae causing liver abscess

10.21203/rs.2.15636/v5 ◽

2020 ◽

Author(s):

Tao Chen ◽

Guofeng Dong ◽

Siqin Zhang ◽

Xiucai Zhang ◽

Yajie Zhao ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Biofilm Formation ◽

Iron Chelator ◽

Infection Model ◽

Invasive Infection ◽

Liver Abscesses ◽

Severe Infections ◽

Lower Expression ◽

Additional Iron

Abstract Background: Klebsiella pneumoniae is considered the most clinically relevant species of Enterobacteriaceae, known to cause severe infections including liver abscesses. To the best of our knowledge, a large proportion of iron in the human body is accumulated and stored in the liver. We hypothesize that increased iron availability is an important factor driving liver abscess formation and we therefore aim to understand the effects of iron on K. pneumoniae causing liver abscesses. Results: All tested K. pneumoniae clinical isolates, including those isolated from liver abscesses and other abdominal invasive infection sites, grew optimally when cultured in LB broth supplemented with 50 μM iron and exhibited the strongest biofilm formation ability under those conditions. Decreased growth and biofilm formation ability were observed in all tested strains when cultured with an iron chelator (P<0.05). The infection model of G. mellonella larvae indicated the virulence of liver abscess-causing K. pneumoniae (2/3) cultured in LB broth with additional iron was significantly higher than those under iron-restricted conditions (P<0.05). The relative expression levels of the four siderophore genes (iucB, iroB, irp1, entB) in K. pneumoniae strains isolated from liver abscesses cultured with additional iron were lower than those under iron-restricted conditions (P<0.05). Conclusions: It is suggested by our research that iron in the environment can promote growth, biofilm formation and enhance virulence of K. pneumoniae causing liver abscesses. A lower expression of siderophore genes correlates with increased virulence of liver abscess-causing K. pneumoniae. Further deeper evaluation of these phenomena is warranted.

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Clinicopathological study on presentation, diagnosis and management of liver abscess in Bhopal region

International Surgery Journal ◽

10.18203/2349-2902.isj20173391 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2572

Author(s):

Anshul Siroliya ◽

Mahendra Damor ◽

M. C. Songra

Keyword(s):

Observational Study ◽

Liver Abscess ◽

Prospective Observational Study ◽

Pyogenic Liver Abscess ◽

Amoebic Liver Abscess ◽

Age Group ◽

Catheter Drainage ◽

Liver Abscesses ◽

Male Preponderance ◽

Amoebic Abscess

Background: This prospective observational study is carried out to study cases of liver abscess and to determine demographic profile, spectrum of clinical presentations, aetiology, laboratory investigations. The objective of the study was to evaluate efficacy of Ultrasonographic (radiological) studies in determining the aetiology and in differentiating from other liver pathologies which may change the treatment outcome, bacteriological and serological characteristics, to study the influence of alcohol, diabetics and immunocompromised diseases (esp. HIV) leading to increased incidence of liver abscess and to evaluate efficacy, recurrence rate, complications, morbidity and mortality, duration of hospital stay associated with different management Strategies.Methods: This prospective observational study was carried out in Department of Surgery, Gandhi Medical College Bhopal and Associated Hamidia Hospital, Bhopal between July 2015 to October 2016.Results: Amoebic abscess (74%) is more common than pyogenic abscess (26%). Amoebic abscess is common in the age group of 31-50 years (73%), pyogenic in the age group of 51-70 years (73.1%). Male preponderance is found in case of amoebic liver abscess (90.5%). Right lobe involvement in common. Right upper quadrant pain, tenderness and fever are the most common clinical features. Alcoholism is most common risk factor (71.6%) and diabetes mellitus has strong association with pyogenic liver abscess (15.4%). E coli (19.2%) and klebsiella (11.5%) are the most common organisms cultured. Medical therapy is more useful in case of amoebic liver abscess (58.1%) while catheter drainage is more useful in case of pyogenic liver abscess (61.5%). Pleuropulmonary complications are much more common and complications rate is more common among pyogenic group.Conclusions: In our study, alcohol was found to be the most common predisposing factor for liver abscesses (68%), this underpin the finding of other studies. Amoebic liver abscess is a medically treated common infection prevailing in unhygienic condition, affecting people mostly between 30-40 years of age whereas pyogenic liver abscess patient commonly falls between 50-70 years age group. Both liver abscesses show a male preponderance. The present study also corroborates the catheter drainage procedure as a superior modality in treating pyogenic liver abscess.

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Prognostic Factors and Visual Outcomes of Pyogenic Liver Abscess-Related Endogenous Klebsiella pneumoniae Endophthalmitis: A 20-year retrospective review

Scientific Reports ◽

10.1038/s41598-018-37643-y ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 10

Author(s):

Yi-Hua Chen ◽

Ya-Han Li ◽

Yu-Jr Lin ◽

Yen-Po Chen ◽

Nan-Kai Wang ◽

...

Keyword(s):

Prognostic Factors ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Retrospective Review ◽

Pyogenic Liver Abscess ◽

Visual Outcomes

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Novel complication of an emerging disease: Invasive Klebsiella pneumoniae liver abscess syndrome as a cause of acute respiratory distress syndrome

Clinics and Practice ◽

10.4081/cp.2018.1021 ◽

2018 ◽

Cited By ~ 2

Author(s):

Anupam Gupta ◽

Saad Bhatti ◽

Anatoly Leytin ◽

Oleg Epelbaum

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Klebsiella Pneumoniae ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Liver Abscess ◽

English Language ◽

Distress Syndrome ◽

Pyogenic Liver Abscess ◽

The Subject ◽

Language Literature

Klebsiella pneumoniae is an increasingly recognized cause of a unique invasive syndrome manifesting as pyogenic liver abscess and hematogenous extrahepatic dissemination to a variety of sites, including the lung. Originally described only in Asia, this entity has now been reported across continents and ethnicities. Intrathoracic complications of invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS) have been characterized sporadically but have not been the subject of an all-encompassing investigation. Review of the English-language literature yields no reports of the acute respiratory distress syndrome as a consequence of IKPLAS. Herein we report what, to our knowledge, is the first such description.

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