Primary Liver Abscess Due toKlebsiella pneumoniaein Taiwan

Abstract

Pyogenic liver abscess is an uncommon complication of intra-abdominal or biliary tract infection and is usually a polymicrobial infection associated with high mortality and high rates of relapse. However, over the past 15 years, we have observed a new clinical syndrome in Taiwan: liver abscesses caused by a single microorganism, Klebsiella pneumoniae. We reviewed 182 cases of pyogenic liver abscess during the period September 1990 to June 1996; 160 of these cases were caused by K. pneumoniae alone, and 22 were polymicrobial. When patients with K. pneumoniae liver abscess were compared with those who had polymicrobial liver abscess, we found higher incidences of diabetes or glucose intolerance (75% vs. 4.5%) and metastatic infections (11.9% vs. 0) and lower rates of intra-abdominal abnormalities (0.6% vs. 95.5%), mortality (11.3% vs. 41%), and relapse (4.4% vs. 41%) in the former group. Liver abscess caused by K. pneumoniae is a new clinical syndrome that has emerged as an important infectious complication in diabetic patients in Taiwan.

Liver abscess caused by Klebsiella pneumoniae: two case reports

“…First reported from Taiwan as a solitary organism in PLA [4], in recent studies Klebsiella pneumoniae was recognized as the leading pathogen of PLA in Asia and Western countries [2,3]. Furthermore, it was found to be associated with Asian ethnicity, diabetes mellitus and cryptogenic liver abscesses [2,3,5].…”

“…Some studies showed a better prognosis for patients with Klebsiella-associated PLA than for other bacterial liver abscesses [4,9]. However, a higher incidence of metastatic infections at other sites was shown in patients with Klebsiella related PLA [9].…”

Outcome of ultrasound guided pigtail catheter drainage of liver abscesses a prospective study of 126 cases

“…25,26 However, Asian series have reported Klebsiella to be the most frequently isolated bacteria. [27][28][29][30] CECT abdomen was performed in 13 cases in present series and showed no additional benefit. Amoebic serology was performed, because of endemicity of amoebiasis in our region and because of financial constraints, as most of our patens belonged to poor economic status, comparable with the available studies.…”

Clinical Presentation, Evaluation and Management of Liver Abscess

“…These are known as cryptogenic abscesses. [9][10] Certain risk factors for abscess development have been described, including recent bowel surgery, diabetes, alcoholism and other immuno-compromised states such as human immunodeficiency virus infections. The most frequently isolated bacteria on pus culture was Escherichia coli (44%) closely followed by Klebsiella species (33%).…”