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Infectious causes of acute pancreatitis: A systematic review
Zaid Imam1, C Roberto Simons-Linares2, Prabhleen Chahal2
1Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI, USA.
Background:
Infectious etiologies of acute pancreatitis (AP) are rare and include viruses, bacteria, mycobacteria, parasites, and fungi. We aimed to conduct a comprehensive review on infectious etiologies of AP analyzing the frequency, clinical features, and outcomes of individuals presenting with this condition.
Methods:
Eligible articles reporting on AP attributed to infectious etiologies were included. A comprehensive literature search of PubMed from time of inception and until September 6,2019 was performed using all relevant MeSH (medical subject heading) keywords. Articles were assessed for eligibility and independently reviewed by two reviewers for clinical features of AP, local complications, and mortality. Methodological quality of included studies was evaluated using the Murad tool.
Results:
A total of 212 articles were included, of which 168 (79.2%) were at high risk of bias. 320 cases of AP were identified. Viruses were the leading etiology of infection attributed AP (65.3%) followed by helminths (19.1%), and bacteria (12.5%). Protozoa, mycobacteria, and fungi accounted for the remaining 3.1% of cases. Mean age was 40.5 ± 18.4 years and M:F ratio was 1.94:1. Mortality occurred in 50 patients. Mortality rate was higher in the virus attributed AP patients than AP from other infectious etiologies (21.8% vs. 7.0%, p < 0.0005).
Interpretation:
Literature quality on infection attributed AP is limited. Virus attributed AP appears to carry a higher mortality than other etiologies of infection attributed AP.
Insights
Infectious causes of acute pancreatitis (AP) are uncommon, with viruses being the most frequent. Virus-attributed AP has a significantly higher mortality rate compared to other infectious causes.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Epidemiology
Background:
- Infectious etiologies of acute pancreatitis (AP) are rare but diverse, including viruses, bacteria, and parasites.
- Understanding the frequency, clinical presentation, and outcomes of infectious AP is crucial for patient management.
Purpose of the Study:
- To conduct a comprehensive review of infectious etiologies of acute pancreatitis (AP).
- To analyze the frequency, clinical features, and outcomes of AP cases attributed to infections.
Main Methods:
- A systematic literature search of PubMed was conducted up to September 2019.
- 212 articles reporting on infectious AP were included and reviewed for clinical data and outcomes.
- Methodological quality was assessed using the Murad tool.
Main Results:
- 320 cases of infectious AP were identified, with viruses as the leading cause (65.3%), followed by helminths (19.1%) and bacteria (12.5%).
- The overall mortality rate was 15.6% (50/320 patients).
- Virus-attributed AP showed a higher mortality rate (21.8%) compared to other infectious etiologies (7.0%).
Conclusions:
- The quality of literature on infection-attributed AP is limited, with most included studies having a high risk of bias.
- Virus-attributed AP is associated with a significantly higher mortality risk than AP caused by other infectious agents.
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