A 10-year's survey analysis of the clinical features of pyogenic liver abscess disease in hospital

Abstract

Abstract: Objective To investigate the changes in disease characteristics of patients with pyogenic liver abscess (PLA) hospitalized in Ruijin Hospital of Shanghai Jiaotong University School of Medicine in the latest 10 years.Methods To retrospectively analyze the clinical data of 106 patients with PLA who were hospitalized in the Department of infectious diseases, Ruijin Hospital from March 2010 to October 2020.Results The incidence of PLA has increased in recent years, and the disease predominantly affects male patients, with a peak age range of 50-80 years. Among all the affected individuals, 80%-90% had elevated neutrophils with acute C-reactive protein elevation, and more than half of the patients developed anemia with reduced albumin and prolonged erythrocyte sedimentation rate. Among the common clinical features, fever and chills occurred in nearly 90% of cases, general malaise in 50%, and right upper abdominal pain in 25%. 45 patients had positive pus cultures or blood cultures, and 5 patients (11.1%) were identified by second-generation sequencing, of which 33 were positive for Klebsiella pneumoniae (29 pus cultures and 4 blood cultures), accounting for 64.7% of culture-positive organisms, followed by 6 cases of Escherichia coli (5 pus cultures and 1 blood culture), accounting for 11.8%. 89 patients were combined with one or more underlying diseases, of which diabetes mellitus accounted for 57 cases (64.0%), and 11 cases (12.4%) have transcatheter arterial chemoembolization (TACE).Conclusion Diabetes mellitus is the main underlying disease of PLA, and cases caused by interventional operation of liver including TACE is rising annually. Klebsiella pneumoniae is the main causative agent of PLA. The second-generation sequencing technique has its advantages. Appropriate antibacterial drugs should be selected according to the pathogenic and pharmacological characteristics in the treatment.

Key words: Pyogenic liver abscess, Clinical features, Klebsiella pneumoniae, Interventional operation, Second-generation sequencing

SHANG Da-bao, WU Bo-ming, ZHANG Jin-ming, TANG Wei-liang, ZHAO Gang-de, LI Zi-qiang, LU Jie, XIE Qing, SHI Dong-mei, XIANG Xiao-gang. A 10-year's survey analysis of the clinical features of pyogenic liver abscess disease in hospital[J]. Chinese Hepatolgy, 2022, 27(3): 334-336.

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