Clinical features of gas-forming liver abscesses: comparison between diabetic and nondiabetic patients

Lee, Chang Jae; Han, Sang Young; Lee, Sung Wook; Baek, Yang Hyun; Roh, Myung Hwan; Lee, Jong Hoon; Jang, Jin Seok; Han, Jin Yeong; Cho, Su Hyun; Choi, Seok Reyol

doi:10.3350/kjhep.2010.16.2.131

Cited by 14 publications

(11 citation statements)

References 8 publications

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“…In this study, gas‐forming abscesses in the DM and non‐DM groups accounted for 11.4% and 5.0% of the PLA cases, respectively. This difference was statistically significant; therefore, DM patients are more susceptible to gas‐forming abscesses, and this conclusion confirms previous findings [12,23–28]. Diabetic patients, especially patients whose plasma glucose is poorly controlled, provided a beneficial environment for the growth of gas‐forming microorganisms.…”

Section: Discussionsupporting

confidence: 89%

Liver abscesses in adult patients with and without diabetes mellitus: an analysis of the clinical characteristics, features of the causative pathogens, outcomes and predictors of fatality: a report based on a large population, retrospective study in China

Tian

Yao

Zhang

et al. 2012

Clinical Microbiology and Infection

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In China, there are four types of liver abscesses (LAs) that meet the clinical criteria. Pyogenic liver abscesses (PLAs) and amoebic liver abscesses (ALAs) are two of the most common types of abscesses, followed by fungal liver abscesses (FLAs) and hydatid secondary liver abscesses (HsLAs). Diabetes mellitus (DM) is associated with the development of PLAs. However, there is a lack of population-based studies that have evaluated the underlying relationship between LAs (mainly PLAs and FLAs) and DM. We conducted a retrospective study based on a large population to identify the potential differences and factors that affect the mortality of PLA patients in DM and non-DM groups. Our results revealed that the prevalence of DM is 44.3% (158/357) in PLA patients and 35.3% (18/51) in FLA patients. Compared with the non-DM patients, statistically significant differences were found in DM patients according to symptomatology, clinical manifestations, laboratory findings, microbiological characteristics, antimicrobial resistance, clinical treatments and outcomes in relation to mortality. In addition, the status of antibiotic resistance to E. coli and K. pneumoniae, which were isolated from the patient samples, is severe in the area in which the study was conducted. Regarding the treatment of PLAs, our study indicated that broad-spectrum antimicrobial therapy and drug combinations should be recommended and initiated before the pathogens are cultured and identified. In the clinic, therapies that combine percutaneous drainage with antibiotics and surgery with antibiotics are the two most useful strategies for treating an LA. These two combined treatments resulted in satisfactory cure rates. In the DM and non-DM groups, the cure rates for percutaneous drainage with antibiotics were 90.3% and 92.0%, respectively, and the cure rates for surgery with antibiotics were 93.9% and 95.2%, respectively.

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Section: Discussionsupporting

confidence: 89%

Liver abscesses in adult patients with and without diabetes mellitus: an analysis of the clinical characteristics, features of the causative pathogens, outcomes and predictors of fatality: a report based on a large population, retrospective study in China

Tian

Yao

Zhang

et al. 2012

Clinical Microbiology and Infection

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“…Compared to the past, patients now have more underlying co‐morbidities and there is an increasing incidence of underlying malignancy. Similar data from Denmark, Korea and America also indicated a rising trend of T2DM and malignancy amongst PLA patients . As compared to the earlier data (1993–1997), there is a sharp increase in PLA mortality rate (from 0% to 13%) and this is likely secondary to patients presenting sicker, in a poorer physiological state and immuno‐compromised with underlying T2DM.…”

Section: Discussionsupporting

confidence: 70%

Predictors of therapy failure in a series of 741 adult pyogenic liver abscesses

Leow

et al. 2014

J Hepato Biliary Pancreat

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There is an increasing PLA incidence with increasing ESBL resistance. Percutaneous drainage should be considered early for elderly patients (≥55-years-old), with multiple abscesses, malignancy as etiology or who required endoscopic intervention. We should have a low threshold for surgical intervention for patients with ECOG performance status ≥2, co-morbidity of hypertension or hyperbilirubinaemia.

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“…2,5,6 However, some studies from Southern Korea and Denmark reported opposite results. 3,4,18 We consider that PLA shows some unique characteristics in the population of Taiwan. Further epidemiological comparisons among other populations are indicated for PLA.…”

Section: Parametersmentioning

confidence: 99%

Impact of advanced age on inpatients with pyogenic liver abscess in Taiwan: A nationwide claim-based analysis

Kang

Hwang²

2011

Journal of the Chinese Medical Association

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Background: Pyogenic liver abscess (PLA) is seen as an endemic disease in population of Taiwan. The impact of advanced age on inpatients with PLA remains unclear. Methods: Data was collected and analyzed from claims of discharges by inpatients with PLA, using the National Health Insurance Research Database of 2007. Results: A total of 2319 subjects and 2651 related discharges were enrolled, including 939 subjects/1077 discharges !65 years and 1380 subjects/1574 discharges <65 years. Subjects !65 years had significantly higher ratios of females to males, nephropathy, biliary tract diseases, liver cirrhosis and gastroenterological cancers than those <65 years. Hepatic/intra-hepatic duct cancers accounted for the most comorbid gastroenterological cancers. Discharged of subjects !65 years had longer hospital stays, more in-hospital death/critical discharge, and a higher ratio of acute low respiratory conditions (ALRC) and urological infections than those of subjects <65 years ( p < 0.05). The inpatient costs for subjects !65 years were significantly higher than those for subjects age<65 years in blood products, hemodialysis and total hospitalization. Comorbidities, such as nephropathy, biliary tract diseases, liver cirrhosis, gastroenterological cancers, ALRC and urological infections were predictive variables associated with age !65 years in patients with PLA, as were being female and in-hospital death/critical discharge. Nephropathy and gastroenterological cancers were predictive variables associated with poor prognosis (in-hospital death/critical discharge) in both PLA patients age < and !65 years ( p < 0.05). Diabetes mellitus featured predominantly, but had no impact on distribution and prognosis. Conclusion: Advanced age (!65 years) had an impact on the aforementioned characteristics and predictive variables in inpatients with PLA. Physicians should pay attention and treat aged PLA patients with greater care, especially those cares with comorbid nephropathy or gastroenterological cancers.

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Clinical features of gas-forming liver abscesses: comparison between diabetic and nondiabetic patients

Abstract: Gas-forming liver abscesses are not uncommon in cases of pyogenic liver abscesses and are associated with high morbidity and mortality rates. The clinical manifestations and complications do not differ significantly between DM and non-DM patients.

Cited by 14 publications

References 8 publications

Liver abscesses in adult patients with and without diabetes mellitus: an analysis of the clinical characteristics, features of the causative pathogens, outcomes and predictors of fatality: a report based on a large population, retrospective study in China

Liver abscesses in adult patients with and without diabetes mellitus: an analysis of the clinical characteristics, features of the causative pathogens, outcomes and predictors of fatality: a report based on a large population, retrospective study in China

Predictors of therapy failure in a series of 741 adult pyogenic liver abscesses

Impact of advanced age on inpatients with pyogenic liver abscess in Taiwan: A nationwide claim-based analysis

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