The Comparison of Clinical Course and Results of Treatment Between Gas-Forming and Non–Gas-Forming Pyogenic Liver Abscess

Abstract

The gas-forming liver abscess may be a disease of wide spectrum of severity and may run a fulminating course. Strong antibiotics with early adequate drainage are mandatory. Surgery should not be delayed if necessary.

Clinical Significance and Mechanism of Gas Formation of Pyogenic Liver Abscess Due toKlebsiella pneumoniae

“…We observed a higher proportion (32%) than previous studies (5,11,19,22), probably because the enrollment of patients was through an emergency department. Our case fatality rate (32%) was compatible with those reported in two studies (30.4 and 37.1%) of GFPLA (17,22), which is much higher than those in unspecified liver abscess (3,4,9,18).…”

“…Over the past 2 decades, its case fatality rate was around 11.5 to 40% (6,10,18,22). Gas-forming pyogenic liver abscess (GFPLA), which accounts for 7 to 24% of pyogenic liver abscess (5,11,12,19,21,22), has a high fatality rate in spite of aggressive management (27.7 to 37.1%) (5,17,22). Klebsiella pneumoniae is the most common pathogen of pyogenic liver abscesses in Taiwan (2,3,5,22), especially in GFPLA (5) and in patients with diabetic mellitus (DM) (2).…”

“…GFPLA is uncommon in western countries (11,16,19) but is often reported in Taiwan (5,17,22). We observed a higher proportion (32%) than previous studies (5,11,19,22), probably because the enrollment of patients was through an emergency department.…”

Emphysematous Liver Abscesses Complicated by Septic Pulmonary Emboli in Patients with Diabetes: Two Cases

“…The death rate is estimated to be 27.7-30.4% in cases of emphysematous liver abscess (1,3), which is higher than that observed in cases of non-gas-forming liver abscesses (2-12%) (4,5). This difference can be explained by the fact that patients with DM tend to contract emphysematous liver abscesses.…”

“…According to previous reports, emphysematous liver abscesses often occur in patients with uncontrolled diabetes mellitus (DM) and cause complications in many cases (1,2). The death rate has been reported to be approximately 30% (1,3), which is higher than that of nongas forming liver abscesses (4,5). I herein describe two cases of emphysematous liver abscesses complicated by septic pulmonary emboli in patients with poorly controlled DM.…”