scholarly journals Clinical Significance of Serum Albumin/Globulin Ratio in Patients With Pyogenic Liver Abscess

2021 ◽  
Vol 8 ◽  
Author(s):  
Jia Zhang ◽  
Tao Wang ◽  
Yi Fang ◽  
Mengzhou Wang ◽  
Wuming Liu ◽  
...  

Pyogenic liver abscess (PLA) remains a significant challenge for modern clinicians. Serum albumin/globulin ratio (AGR) can reflect the progress of many diseases. However, the clinical significance of AGR in PLA has not been evaluated. The aim of this study was to explore the effect of AGR on the clinical characteristic and prognosis in PLA patients. This retrospective study included 392 PLA patients who admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January, 2007 to December, 2016. The medical records on admission were collected. Compared with the healthy controls and the patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower levels of AGR. The mean level of AGR in PLA patients was 1.02 ± 0.25. There were 179 (45.4%) patients with AGR > 1.02 and 213 (54.6%) patients with AGR ≤ 1.02. The baseline data and treatment plans of PLA patients with high or low AGR were comparative. However, PLA patients with a low AGR had higher body temperature, leukocytes and neutrophils, lower hemoglobin, poorer liver and coagulation function, larger abscess diameter, higher positive rate of pus culture and proportion of Escherichia coli, and were more susceptible to multiple bacteria. Moreover, PLA patients with a low AGR had more complications, including systemic inflammatory response syndrome (SIRS), peritoneal effusion and pleural effusion. And it also needs longer time for temperature normalization and hospital stay. In conclusion, PLA patients have lower AGR and lower AGR is associated with worse clinical manifestations, more complications and poorer prognosis. Thus, monitoring of AGR is of great clinical significance for evaluating the progress of PLA patients.

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Wenhao Wu ◽  
Wenjia Fan ◽  
Zhewen Zhou ◽  
Shouhao Wang ◽  
Chengan Xu ◽  
...  

Introduction: Pyogenic liver abscess (PLA) is a serious infectious disease of the liver. PLA caused by Fusobacterium nucleatum is extremely rare. Here we report the first case of liver abscess caused by F. nucleatum in China. Case Presentation: The case was a 34-year-old female patient admitted to the hospital due to high fever. The diagnosis of liver abscess was confirmed by imaging studies and liver puncture. We finally confirmed the pathogen as F. nucleatum by next-generation sequencing (NGS). After the targeted anti-infective treatment, the patient recovered and discharged. Conclusions: As a new microbial detection method, NGS can still help in clinical practice. In addition, to improve the positive rate of anaerobic bacteria culture, we should pay attention to avoid contact with air in the process of specimen collection when the pathogenic bacteria are suspected to be anaerobic bacteria.


Author(s):  
Sergio Renato PAIS-COSTA ◽  
Sergio Luiz Melo ARAUJO ◽  
Victor Netto FIGUEIREDO

ABSTRACT Background: Percutaneous drainage for pyogenic liver abscess has been considered the gold-standard approach for the treatment on almost of the cases. However, when percutaneous drainage fails or even in some especial situations, as multiloculate abscess, lobe or segment surgical resection can solve infectious clinical condition. Aim: To report a series of patients who underwent hepatectomy for pyogenic liver abscess performed by a single surgical team. Methods: Eleven patients were operated with ages ranging from 45-73 years (mean and median 66 years). There were eight men and three women. The etiologies were: idiopathic (n=4), biliary (n=2), radiofrequency (n=2), direct extension (n=1), portal (n=1), and arterial (n=1). The mean lesion diameter was 9.27 cm (6-20 cm). Results: The mean operation length was 180 min (120-300). The mean intra-operative blood loss was 448 ml (50-1500). Surgical approaches were: right hepatectomy (n=4), left hepatectomy (n=3), left lateral sectioniectomy (n=1), right posterior sectioniectomy (n=2), resection of S8 (n=1), and S1 (n=1). Postoperative morbidity rate was 30%, while mortality was null. Median hospital stay was 18 days (5-45). The median follow-up period was 49 months (13-78). There was single lesion recurrence. Conclusion: Hepatectomy can be done as exception approach for pyogenic hepatic abscess treatment; it is a good therapeutic option in special situations.


Author(s):  
Vineet Jain ◽  
Smita Manjavkar ◽  
Divya Rajput ◽  
Abhinav Jain ◽  
. Jyotsana ◽  
...  

Background: Liver abscess has shown a major change in demographics, etiology, diagnosis, and treatment over the past 100 years. The modern diagnostics like ultrasound and computed tomography to locate and drain the abscess have reduced the mortality to 2-12%. However, due to the complications of liver abscess especially the amebic ones the morbidity is still high. This study aims to study the correlation of various LFT parameters with abscess volume for early detection of high risk patients and early treatment thus reducing morbidity.Methods: The study was conducted over a period of 6 months on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. The data was recorded and compiled in excel sheets and analyzed using correlation coefficient (R) method.Results: The mean age of the patients was 41.2 years with male preponderance. Amoebic liver abscess (88%) was predominant over pyogenic liver abscess (12%). Alcoholism (48%), smoking (42%) and diabetes mellitus (18%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 88% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. Complications seen were pleural effusion (10%) and ascites (4%). On analysis, liver abscess size is significantly positively correlated with INR, ALP, liver enzymes, and negatively correlated with serum albumin level.Conclusions: Liver abscess size was found to be positively correlated with INR and alkaline phosphatase (ALP), liver enzymes (SGOT, SGPT) and negatively correlated with serum albumin levels. There was no correlation of abscess size and bilirubin levels. Hence, LFT can be used to estimate the liver abscess size and predict the severity and prognosis of patient.


2017 ◽  
Vol 4 (3) ◽  
pp. 1033
Author(s):  
Kong Jun ◽  
Leng Tongmin ◽  
Gong Jianping ◽  
Tang Maoming

Background: Aiming at diagnosing at an early stage, minimizing the misdiagnosis rate and improving the prognosis, the author has investigated the clinical characteristics, diagnosis and treatment of primary liver cancer mimicking liver abscess with a summary and discussion.Methods: All of the 11 cases of primary liver cancer mimicking liver abscess, diagnosed during January 2009 to December 2015, were retrospectively viewed in terms of clinical manifestations, laboratory tests, radiological feature, diagnosis and treatment. And statistic analysis was made in all aspects mentioned above with that of pyogenic liver abscess and other types of liver cancer diagnosed in the corresponding period.  Results: The clinical manifestations of the 11 cases were mostly characterized by fever, abdominal pain and weight loss. There was no significantly statistic difference between the study group and any of the three matched groups in underlying disease and lab results. All of the 11 patients were treated with enhanced antibiotics as basic therapy. Furthermore, eight cases accepted surgical operation, among them, one object underwent puncture and drainage of the liver abscess by ultrasound (PDLA) twice pre-operation, one object underwent PDLA and hepatic arteriography pre-operation and death in hospital post-operation, one object suffered myocardial infarction post-operation. In addition, three cases received conservative treatment only, in which, one object died in hospital.Conclusions: It is difficult to distinguish primary liver cancer mimicking liver abscess from pyogenic liver abscess as there are no specific clinical manifestations and laboratory findings which is prone to leading to misdiagnosis. What’s worse, the prognosis is so poor that high alert and close follow-up are required as well as early diagnosis and treatment. 


Author(s):  
Otto Mauro dos SANTOS-ROSA ◽  
Henrique Simonsen LUNARDELLI ◽  
Marcelo Augusto Fontenelle RIBEIRO-JUNIOR

ABSTRACT Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource.


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.


Author(s):  
Siqin Zhang ◽  
Xiucai Zhang ◽  
Qing Wu ◽  
Xiangkuo Zheng ◽  
Guofeng Dong ◽  
...  

Abstract Background Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) has emerged as a life-threatening disease worldwide. However, to date, a limited number of scholars have attempted to systematically elucidate the characteristics of KP-PLA. The aim of the present study was to analyze clinical, microbiological, and molecular epidemiological characteristics of KP-PLA patients in Southeastern China. Methods The KP-PLA cases from a tertiary teaching hospital in China from January 2016 to December 2017 were systemically studied and elucidated comprehensively. The virulence factors, resistant spectrum, and clones of K. pneumoniae isolates were identified with string test, polymerase chain reaction (PCR), antimicrobial susceptibility test, and multilocus sequence typing. Moreover, the characteristics in KP-PLA patients with and without other hepatobiliary diseases (OHD) were also been compared. Results A total of 163 KP-PLA cases were enrolled, in which the majority of those cases were senior males, and often associated with multiple underlying diseases, including diabetes (49.7%). The remaining cases belonged to healthy individuals (50.3%). The clinical symptoms were common but nonspecific, characterized by increased inflammatory parameters and abnormal liver function parameters. The abscess was often right-sided solitary presentation (58.3%). Cephalosporin or carbapenem plus metronidazole combined with percutaneous puncture or catheter drainage were favorable therapeutics. Although low resistance rates of commonly used antimicrobial drugs (< 10%) were observed, twelve strains were identified as multidrug resistant (MDR) strains, and were mainly isolated from the OHD patients. The hypermucoviscosity, as well as K1 and K2 serotypes accounted for 30.7, 40.5, and 19.0%, respectively. Except for iroN (24.5%) and magA (45.4%), the high prevalence of virulence genes (e.g. aerobactin, rmpA, mrkD, fimH, uge, ureA, entB, ybtA, kfuBC, and wcaG) was identified (68.7–100.0%). Additionally, ST23 was found as a predominant sequence type (ST; 38.7%), and three novel STs (ST3507, ST3508 and ST3509) were noted as well. Conclusions The present study reported the abundant hvKp strains in KP-PLA, as well as convergence of hypervirulent and MDR K. pneumoniae isolates from the KP-PLA patients, particularly those cases with OHD. Given the various clinical manifestations and destructive pathogenicity, determination of the comprehensive characteristics of such isolates is highly essential to effectively carry out for optimal management and treatment of KP-PLA.


1974 ◽  
Vol 75 (1) ◽  
pp. 133-140 ◽  
Author(s):  
B. E. Senior

ABSTRACT A radioimmunoassay was developed to measure the levels of oestrone and oestradiol in 0.5–1.0 ml of domestic fowl peripheral plasma. The oestrogens were extracted with diethyl ether, chromatographed on columns of Sephadex LH-20 and assayed with an antiserum prepared against oestradiol-17β-succinyl-bovine serum albumin using a 17 h incubation at 4°C. The specificity, sensitivity, precision and accuracy of the assays were satisfactory. Oestrogen concentrations were determined in the plasma of birds in various reproductive states. In laying hens the ranges of oestrone and oestradiol were 12–190 pg/ml and 29–327 pg/ml respectively. Levels in immature birds, in adult cockerels and in an ovariectomized hen were barely detectable. The mean concentrations of oestrone and oestradiol in the plasma of four non-laying hens (55 pg/ml and 72 pg/ml respectively) and one partially ovariectomized hen (71 pg/ml and 134 pg/ml respectively) were well within the range for laying hens. It is evident that the large, yolk-filled follicles are not the only source of oestrogens in the chicken ovary.


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