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Analysis of 15 cases from a monocentric cohort of 307 liver abscesses

Etienne Canouï1, Geoffrey Rossi1, Yann Nguyen1

  • 1Department of Internal Medicine, Beaujon Hospital, GHU AP-HP. Nord-Université Paris Cité, Paris, France.

Mycoses
|August 3, 2023
PubMed
Abstract

Insights

Candida pyogenic liver abscesses (C-PLA) are rare but severe, often linked to comorbidities and sepsis. C-PLA cases show a higher recurrence risk, suggesting a need for more intensive treatment strategies.

Area of Science:

  • Medical Mycology
  • Hepatology
  • Infectious Diseases

Background:

  • Candida species are infrequently identified in pyogenic liver abscesses (PLA), particularly outside of hematological patient contexts.
  • This study focuses on Candida pyogenic liver abscesses (C-PLA), distinguishing them from bacterial PLA (B-PLA).

Purpose of the Study:

  • To investigate the risk factors, clinical and microbiological features, management, and outcomes of C-PLA.
  • To compare C-PLA cases with B-PLA to identify distinct characteristics and associations.

Main Methods:

  • Retrospective analysis of C-PLA and B-PLA cases from a monocentric liver abscess database (2010-2018).
  • Definition of unfavorable course included treatment failure, recurrence, or death within 3 months.
  • Multivariate analysis was employed to identify independent risk factors and associations.

Main Results:

  • Fifteen C-PLA and 292 B-PLA cases were analyzed; all C-PLA cases were of biliary origin and polymicrobial.
  • Patients with C-PLA frequently had comorbidities, sepsis requiring intensive care (53.3%), and a median antifungal treatment duration of 42 days.
  • Independent risk factors for C-PLA included a history of malignancy, prior liver abscess, and sepsis with severity criteria. C-PLA was associated with a significantly higher risk of recurrence.

Conclusions:

  • Candida liver abscesses in non-neutropenic patients represent a rare yet severe clinical entity.
  • The high recurrence rate observed in C-PLA necessitates consideration of more aggressive and intensive treatment protocols.
Keywords:
Candida liver abscessrecurrence

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