The influence of early adoption of nonenhanced computed tomography on management of patients with pyogenic liver abscess

Abstract

Background and Aim A pyogenic liver abscess (PLA) is an infectious disease with high in‐hospital mortality. It has no specific symptoms and is difficult to be diagnosed early in the emergency department. Ultrasound is commonly used to detect PLA lesions of PLA, but its sensitivity can be affected by lesion size, location, and clinician experience. Therefore, early diagnosis and prompt treatment (especially abscess drainage) are crucial for better patient outcomes and should be prioritized by clinical physicians. Methods We conducted a retrospective study to compare the effect of early and late (i.e., receiving CT scanning within 48 h and >48 h after admission) adoption of nonenhanced computed tomography (CT) scanning regarding the hospitalization days and interval between admission and drainage of patients with PLA. Results This study included 76 hospitalized patients with PLA in the Department of Digestive Disease of Xiamen Chang Gung Hospital in China who underwent CT examinations from 2014 to 2021. We conducted CT scans on 56 patients within 48 h of admission and on 20 patients more than 48 h after admission. The early CT group had a significantly shorter hospitalization length compared with the late CT group (15.0 days vs. 20.5 days; P = 0.035). Besides, the median time to initiate drainage after admission was also significantly shorter in the early CT group than in the late CT group (1.0 days vs. 4.5 days; P < 0.001). Conclusion Early CT scanning within 48 h of admission may aid in early PLA diagnosis and benefit disease recovery, as revealed by our findings.

Alterations of Gut Microbiota in Pyogenic Liver Abscess Patients with and without Type 2 Diabetes Mellitus

“…The pathogenic bacterium Klebsiella pneumoniae is commonly found in PLA patients with DM. 10 , 38 Zhang et al demonstrated that Klebsiella pneumoniae liver abscesses are mixed abscesses infected by Klebsiella pneumoniae along with other bacteria. 39 Guo et al reported that the relative abundance of Klebsiella in the pus cavity of PLA patients with DM was higher than that in PLA patients without DM.…”