Abcès du foie

Lafont, Emmanuel; Rossi, G.; Rossi, Benjamín; Roux, Olivier; Lastours, Victoire de; Zarrouk, Virginie; Dokmak, Safi; Ronot, Maxime; Leflon, Véronique; Lefort, A.

doi:10.1016/j.antinf.2017.08.001

Cited by 2 publications

(1 citation statement)

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“…Pyogenic liver abscesses (PLA) are a rare but severe infection (incidence, 1.1‐17.6/100 000 individuals per year), 1‐5 associated with 6‐month mortality rates ranging from 3% to 13.7% 6‐8 . Most PLA result from a biliary origin (30%‐70% of PLA), 9 followed by a portal origin (10%‐20%) complicating intra‐abdominal diseases such as appendicitis, diverticulitis, infected gastrointestinal tumors, or chronic inflammatory bowel diseases 10‐12 . More rarely, PLA may result from the infection of pre‐existing hepatic lesions such as cysts, tumors, or hydatid cysts, or occur after an invasive abdominal procedure, typically pancreatoduodenectomy with injury of the hepatic artery, chemo‐embolization, ablation of liver tumors, or liver transplantation.…”

Section: Introductionmentioning

confidence: 99%

Pyogenic liver abscess in liver transplant recipient: A warning signal for the risk of recurrence and retransplantation

Lafont

Roux

Lastours

et al. 2020

Transplant Infectious Dis

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Background: Pyogenic liver abscesses in liver transplant recipients (PLA-LTR) are a rare disease whose specificities compared with PLA in non-transplanted patients (PLA-C) are unknown. Methods: A retrospective case-control study was conducted in a French academic hospital from January 1, 2010, to December 31, 2014. Results: Among 176 patients diagnosed with PLA, 14 were LTR; each case was matched with 3 PLA-C controls by date of PLA diagnosis and pathophysiological mechanism of PLA. Median time from liver transplantation to PLA diagnosis was 34.5 months. Among 14 PLA-LTR, 8/14 (57.1%) had bacteremia and 10/14 (71.4%) had positive PLA cultures. Most commonly isolated bacteria were Enterobacteriaceae (9/14; 64.3%), Enterococcus spp. (4/14; 28.6%), and anaerobic bacteria (3/14; 21.4%). Clinical, radiological, and microbiological characteristics did not significantly differ between PLA-LTR and PLA-C but there was a tendency toward more diabetic patients and a less acute presentation. All but one PLA-LTR were associated with ischemic cholangitis, whereas this was a rare cause among PLA-C (13/14 vs 3/42, respectively, P < .001) among patients with PLA-LTR. In contrast, hepatobiliary neoplasia was rare in PLA-LTR but frequent in PLA-C (1/14 vs 24/42, P = .001). No significant difference was found between PLA-LTR and PLA-C in terms of duration of antibiotic therapy (6.5 and 6 weeks, respectively), PLA drainage rates (10/14 and 26/42, respectively), or mortality at 12 months after PLA diagnosis (2/14 and 5/42, respectively). Recurrence rates within the first year were observed in 6/14 patients (42.9%), and retransplantation was needed in 5/14 (35.7%). Conclusions: Occurrence of PLA in LTR is a severe event leading to high risk of recurrence and retransplantation.

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Section: Introductionmentioning

confidence: 99%