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Gas-forming pyogenic liver abscess: A world review

Coeway Boulder Thng1, Yen Pin Tan2, Vishal G Shelat2

  • 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Annals of Hepato-Biliary-Pancreatic Surgery
|March 15, 2018
PubMed
Abstract

Insights

Gas-forming pyogenic liver abscess (GFPLA) is a distinct entity with high mortality, often linked to diabetes mellitus and Klebsiella pneumoniae. Recognizing GFPLA is crucial for patient outcomes.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Gas-forming pyogenic liver abscess (GFPLA) accounts for up to 30% of pyogenic liver abscesses (PLA).
  • GFPLA presents a higher mortality rate compared to non-GFPLA.
  • Understanding the unique biological characteristics of GFPLA is essential for clinical management.

Purpose of the Study:

  • To conduct a comprehensive global review of gas-forming pyogenic liver abscess (GFPLA).

Main Methods:

  • Literature search conducted in PubMed using specific MeSH terms related to gas-forming liver abscess.
  • Inclusion of thirteen case series comprising 313 GFPLA patients.
  • Tabulation of patient demographics, comorbidities (diabetes mellitus), bacteriology, etiology, symptoms, investigations, operative indications, and mortality rates.

Main Results:

  • GFPLA cases are frequently cryptogenic.
  • No significant differences observed in age, gender, or symptomatology between GFPLA and non-GFPLA.
  • Diabetes mellitus (DM) is significantly more prevalent in GFPLA patients (83.5%) versus non-GFPLA (38.3%).
  • Klebsiella pneumoniae identified as the most common causative pathogen.
  • GFPLA exhibits a substantially higher mortality rate (30.3%) compared to non-GFPLA (9%).

Conclusions:

  • Gas-forming pyogenic liver abscess (GFPLA) is strongly associated with diabetes mellitus (DM).
  • Monomicrobial Klebsiella pneumoniae infection is a key characteristic of GFPLA.
  • GFPLA represents a distinct clinical entity with a high mortality rate, necessitating specific recognition and management strategies.
Keywords:
Gas-forming pyogenic liver abscess

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