Gut Liver.  2011 Jun;5(2):221-227.

A 10-Year Retrospective Analysis of Clinical Profiles, Laboratory Characteristics and Management of Pyogenic Liver Abscesses in a Chinese Hospital

• Zhu X
• Wang S
• Jacob R
• Fan Z
• Zhang F
• Ji G

Abstract

BACKGROUND/AIMS
Pyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The aim of this study was to collect demographic data and clinical, laboratory and microbiological characteristics of PLA patients treated between 2000 and 2010. We also aimed to collect information regarding our management experience of these cases.
METHODS
As a retrospective review, 47 patients with PLA in a tertiary referral center were examined to determine their demographic characteristics, clinical features, and laboratory, imaging, and microbiologic findings as well as the treatment outcome.
RESULTS
Cryptogenic PLA was the most frequently identified type of PLA, while benign biliary tract disease was the most frequently identifiable cause of PLA (18/47 patients; 38.3%). Leukocytosis and elevated alanine transaminase were common laboratory findings and were observed in 35 (74.5%) and 22 (46.8%) patients, respectively. Increased fibrinogen was also detected in 11 of 15 investigated cases (73.3%). Notably, infection-induced thrombocytopenia occurred in 8 patients (17%). Diabetes mellitus was associated with the occurrence of infection induced shock when compared to the non-diabetic group (p<0.05). Patients with two or more comorbid diseases had longer hospitalizations when compared to patients with one comorbid disease or those without comorbidities (p<0.001). The number of days needed to establish diagnosis was correlated with the length of hospitalization (p<0.001). The overall hospital mortality rate was 2.1% (1/47).
CONCLUSIONS
Characteristics of PLA patients from the past 10 years are presented. The number of days needed to establish a PLA diagnosis was correlated with the length of the hospital stay. The hospital stay of PLA patients can be further improved by early diagnosis and effective treatments during the early stages of PLA progression.

Keyword

Asian Continental Ancestry Group; Pyogenic liver abscess; Clinical audit; Early diagnosis; Treatment outcome

MeSH Terms

Alanine Transaminase
Asian Continental Ancestry Group
Biliary Tract Diseases
Clinical Audit
Comorbidity
Diabetes Mellitus
Early Diagnosis
Fibrinogen
Hospital Mortality
Hospitalization
Humans
Length of Stay
Leukocytosis
Liver Abscess, Pyogenic
Retrospective Studies
Shock
Tertiary Care Centers
Thrombocytopenia
Treatment Outcome
Alanine Transaminase
Fibrinogen