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Summary of clinical features of 1800 cases of pyogenic liver abscess
Yu Tian1,2, Diandian Hao1, Jialin Du1
1Department of Hepatic-Biliary-Pancreatic Medicine, the First Hospital of Jilin University, Changchun, Jilin Province.
Objective:
This study aimed to summarize the clinical and microbiological characteristics of patients with pyogenic liver abscess (PLA) and to explore the clinical features of PLA with extrahepatic migratory infection (EMI).
Methods:
A retrospective analysis was conducted on clinical data from 1800 PLA patients at Jilin University First Hospital from January 2019 to December 2023. Patients were divided into two groups based on the presence of EMI: with EMI and without EMI. Clinical features and prognoses of the two groups were compared using rank-sum tests and chi-square tests for continuous and categorical data, respectively.
Results:
PLA patients were predominantly male (65.56%) with an average age of 60. Abscesses were mainly located in the right lobe (64.83%) and were often single (68.17%). Klebsiella pneumoniae was the primary pathogen (68.46%), with 9.50% of strains being multidrug-resistant. The majority of patients improved with effective treatment (96.17%). Compared with the non-EMI group, patients with EMI were younger, had longer hospital stays, smaller abscesses, and a higher incidence of diabetes and cerebrovascular disease, with poorer prognoses.
Conclusion:
PLA is most commonly observed in middle-aged and elderly males, often presenting as single abscesses in the right lobe, with diabetes as a frequent underlying condition. Most patients recover with appropriate antibiotic treatment and ultrasound-guided drainage. PLA patients with EMI generally have poorer outcomes and require special attention.
Insights
Pyogenic liver abscess (PLA) commonly affects elderly males, often caused by Klebsiella pneumoniae. Patients with extrahepatic migratory infection (EMI) typically present younger and have poorer prognoses, requiring special attention.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Pyogenic liver abscess (PLA) is a serious intra-abdominal infection.
- Understanding its clinical and microbiological features is crucial for effective management.
- Extrahepatic migratory infection (EMI) is a potential complication of PLA.
Purpose of the Study:
- To summarize the clinical and microbiological characteristics of PLA patients.
- To explore the clinical features and outcomes of PLA with EMI.
Main Methods:
- Retrospective analysis of 1800 PLA patients (January 2019 - December 2023).
- Comparison of clinical features and prognoses between patients with and without EMI.
- Statistical analysis using rank-sum and chi-square tests.
Main Results:
- PLA predominantly affects males (65.56%), average age 60, with right lobe (64.83%) single abscesses (68.17%).
- Klebsiella pneumoniae was the main pathogen (68.46%), with 9.50% multidrug-resistant strains.
- EMI group patients were younger, had longer hospital stays, smaller abscesses, more diabetes/cerebrovascular disease, and poorer prognoses.
Conclusions:
- PLA is common in middle-aged/elderly males, often linked to diabetes, typically resolving with antibiotics and drainage.
- PLA patients with EMI exhibit distinct clinical features and generally have worse outcomes.
- Special attention is needed for PLA patients with EMI due to poorer prognoses.
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