Analysis of the clinical characteristics of 202 patients with liver abscess associated with diabetes mellitus and biliary tract disease

Abstract

Objective Clinical characteristics of patients with pyogenic liver abscess (PLA) of varying etiologies may be different. This study aimed to analyze the clinical characteristics, pathogenic bacteria, treatment, and prognosis of patients with PLA associated with diabetes and biliary disease. Methods Clinical, imaging, and laboratory data from 202 inpatients with PLA were retrospectively analyzed. Results Eighty-eight patients (43.6%) had a history of diabetes, 73 (36.1%) had a history of underlying biliary tract disease, and 24 (11.9%) had both the diseases. The level of C-reactive protein (CRP) increased in 99.2% (119/120) patients, and the level of procalcitonin (PCT) increased in 95.5% (148/155) patients. The main pathogen of PLA was Klebsiella pneumoniae. The incidence of bloodstream infection increased by 34.4% (22/64) in patients with PLA that was associated with diabetes mellitus, and that of K. pneumoniae infection was 88.6% (39/44). The readmission rate for patients with PLA with underlying biliary diseases was 10.2 to 12.5%. Conclusion The main pathogen of PLA is K. pneumoniae, which is sensitive to most antibiotics. Patients with PLA associated with diabetes were more likely to have bloodstream infections, and the recurrence rate of PLA with underlying biliary diseases was higher than without biliary duct disease.

Maximal diameter of liver abscess independently predicts prolonged hospitalization and poor prognosis in patients with pyogenic liver abscess

“…Data were expressed as number (percentage) or mean ± standard deviation. PCD Percutaneous catheter drainage factors for liver abscess [5,7,[27][28][29][30], and the present study covered a large number of individuals with these risk factors; however, the distribution of patients with these underlying diseases did not differ according to the size of the abscess. The detection rate of colonic lesions by colonoscopic examination also showed no difference according to the size of the abscess.…”

“…Regarding the size of the liver abscess, demographic and isolated microorganisms did not differ according to the size of the liver abscess. Underlying malignancy, DM, biliary tract diseases, and liver cirrhosis are known risk factors for liver abscess [ 5 , 7 , 27 – 30 ], and the present study covered a large number of individuals with these risk factors; however, the distribution of patients with these underlying diseases did not differ according to the size of the abscess. The detection rate of colonic lesions by colonoscopic examination also showed no difference according to the size of the abscess.…”

Percutaneous catheter drainage versus needle aspiration for liver abscess management: an updated systematic review, meta-analysis, and meta-regression of randomized controlled trials

“…Liver abscesses, either pyogenic or amoebic, remain a significant cause of morbidity and mortality in tropical countries (19). Morbidity and mortality are highly affected by several factors such as the presence of diabetes, which is accredited to low immunity, biliary disease, and type of organism, a recently published meta-analysis, Chan et al concluded that klebsiella pneumoniae has lower mortality than non-klebsiella pneumoniae pyogenic liver abscess (40)(41)(42). Liver abscess has been even more common recently due to the increasing biliary interventions (20).…”

Pyogenic Liver Abscess Risk in Patients With Newly Diagnosed Type 2 Diabetes Mellitus: A Nationwide, Population-Based Cohort Study

“…The pathophysiology of KP infection associated with DM is incompletely understood. However, the susceptibility of infection appears to be strongly associated with hyperglycemia Decreased mobilization of polymorphonuclear leukocytes, chemotaxis, and phagocytic activity may occur during hyperglycemia ( 17 – 19 ).…”