Oikonomou Katerina G, Aye Myint
Department of Medicine, New York University School of Medicine, NYU Lutheran Medical Center, Brooklyn, NY, USA.
Am J Case Rep. 2017 Sep 26;18:1028-1033. doi: 10.12659/ajcr.905191.
BACKGROUND Liver abscesses represent a serious infection of hepatic parenchyma and are associated with significant morbidity and mortality. The emergence of a new hypervirulent variant of Klebsiella pneumoniae, which can cause serious infections in the Asian population, is under investigation. We report a case series of six Asian patients hospitalized at our institution from January 2013 to November 2015 for liver abscess due to Klebsiella pneumoniae. CASE REPORT Charts of six Asian patients were retrospectively reviewed. Four patients were male and two were female. The mean age was 53 years (range: 35-64 years). All patients had no known past medical history of immunodeficiency. Three patients had multiple liver abscesses at the time of initial presentation. In five patients, the source of entry of the pathogenic microorganism was unknown and in one patient the suspected source of entry was the gastrointestinal tract. In three patients there was also concomitant Klebsiella pneumoniae bacteremia. The mean duration of antibiotic treatment was seven weeks and the mean duration of hospital stay was 13.5 days. CONCLUSIONS Liver abscess should always be included in the differential diagnosis in cases of sepsis without obvious source and/or in the clinical scenarios of fever, abdominal pain, and liver lesions.
肝脓肿是肝实质的严重感染，与显著的发病率和死亡率相关。一种新型高毒力肺炎克雷伯菌变体的出现正在研究中，该变体可在亚洲人群中引起严重感染。我们报告了2013年1月至2015年11月在我院住院的6例因肺炎克雷伯菌导致肝脓肿的亚洲患者的病例系列。病例报告：对6例亚洲患者的病历进行了回顾性分析。4例为男性，2例为女性。平均年龄为53岁（范围：35 - 64岁）。所有患者既往均无已知免疫缺陷病史。3例患者在初次就诊时患有多发性肝脓肿。5例患者致病微生物的进入源不明，1例患者疑似进入源为胃肠道。3例患者还伴有肺炎克雷伯菌菌血症。抗生素治疗的平均持续时间为7周，平均住院时间为13.5天。结论：在无明显来源的脓毒症病例和/或发热、腹痛及肝脏病变的临床情况下，肝脓肿应始终纳入鉴别诊断。
