Hui Joyce Y H, Yang Michael K W, Cho Danny H Y, Li Allen, Loke Tony K L, Chan James C S, Woo Patrick C Y
Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Hong Kong.
Radiology. 2007 Mar;242(3):769-76. doi: 10.1148/radiol.2423051344.
To retrospectively compare the ultrasonographic (US) appearance and amount of pus obtained at initial aspiration for liver abscesses caused by Klebsiella pneumoniae with those for liver abscesses caused by other bacterial pathogens.
This study had medical ethics committee approval; informed consent was not required. Asian patients with pyogenic liver abscesses in a 5-year period were included. Abscess clinical, laboratory, and microbiologic characteristics and treatment and outcome were analyzed. US images were classified according to the size of the largest liver abscess, the echogenic pattern of the lesion, the presence of any echogenic debris within the lesion, increased through transmission in the posterior aspect of the lesion, and the lesion margin. Clinical and US characteristics of patients with K pneumoniae monomicrobial liver abscesses and those with non-K pneumoniae monomicrobial or polymicrobial liver abscesses were compared. The chi(2) or Fisher exact test was used for categorical variables; the Student t test was used for continuous variables.
There were 120 patients with pyogenic liver abscesses. Median patient age was 69 years (range, 13-94 years). Fifty-nine patients were male, and 61 were female. Fifty patients with K pneumoniae monomicrobial and 33 patients with non-K pneumoniae monomicrobial or polymicrobial liver abscesses underwent US. K pneumoniae monomicrobial liver abscesses were associated with diabetes mellitus (P < .001), higher blood glucose levels at admission (P < .05), predominantly solid US appearances (P < .001), irregular or indistinct lesion margins (P < .05), less than 2 mL of pus aspirated (P < .001), and longer duration of antibiotic treatment (P < .05).
A predominantly solid appearance at US is associated with K pneumoniae monomicrobial liver abscess. K pneumoniae liver abscess is associated with a much smaller quantity of pus at initial aspiration.
回顾性比较肺炎克雷伯菌所致肝脓肿与其他细菌病原体所致肝脓肿初次穿刺时的超声（US）表现及抽出的脓液量。
本研究经医学伦理委员会批准；无需知情同意。纳入5年内患有化脓性肝脓肿的亚洲患者。分析脓肿的临床、实验室和微生物学特征以及治疗和结局。根据最大肝脓肿的大小、病变的回声模式、病变内是否存在任何回声性碎屑、病变后方的透声增强以及病变边缘对US图像进行分类。比较肺炎克雷伯菌单一微生物肝脓肿患者与非肺炎克雷伯菌单一微生物或多微生物肝脓肿患者的临床和US特征。分类变量采用卡方检验或Fisher精确检验；连续变量采用Student t检验。
有120例化脓性肝脓肿患者。患者年龄中位数为69岁（范围13 - 94岁）。59例为男性，61例为女性。50例肺炎克雷伯菌单一微生物肝脓肿患者和33例非肺炎克雷伯菌单一微生物或多微生物肝脓肿患者接受了US检查。肺炎克雷伯菌单一微生物肝脓肿与糖尿病（P <.001）、入院时血糖水平较高（P <.05）、US主要表现为实性（P <.001）、病变边缘不规则或不清晰（P <.05）、抽出脓液少于2 mL（P <.001）以及抗生素治疗时间较长（P <.05）相关。
US主要表现为实性与肺炎克雷伯菌单一微生物肝脓肿相关。肺炎克雷伯菌肝脓肿初次穿刺时抽出的脓液量少得多。
