Zhou Yuanyuan, Lu Guanzhu, Bai Yupan, Bao Yujie, Xu Jie
Department of Infectious Disease, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine 639 Zhizao Ju Road, Huangpu District, Shanghai 200011, China.
Int J Clin Exp Pathol. 2021 Feb 1;14(2):252-260. eCollection 2021.
Pyogenic liver abscess is a life-threatening disease. It is urgent to review the clinical patterns, risk factors, and management of the disease in order to improve the outcome. We retrospectively analyzed 70 cases of pyogenic liver abscess diagnosed and treated at Shanghai Ninth People's Hospital over five years, including the clinical features, management, and outcome. The average age was 63.06 ± 12.33 y. 71.4% (50/70) were males. 85.7% (60/70) patients presented with fever. The major abnormalities in laboratory were increased CRP and liver dysfunction. 77.8% (14/18) pus cultures came with positive reports, while 26.5% (9/34) blood cultures were positive. was the predominant pathogen both in blood (66.7%, 6/9) and pus (64.3%, 9/14) cultures. 42.9% (30/70) patients also had diabetes. Patients with diabetes presented with significantly larger size of abscess ( = 0.014) and were more susceptible to infection ( = 0.002). We revealed HbA1c ( = 0.047), accompanying malignancy ( = 0.030), and septic shock ( = 0.045) were three independent risk factors for PLA. In conclusion: pyrogenic liver abscess was atypical; microbiologic positivity of pus culture was higher than that of blood culture; was the predominant pathogen in pyrogenic liver abscesses, especially in patients with diabetes; and patients with hyperglycemia had poor outcome.
化脓性肝脓肿是一种危及生命的疾病。为改善治疗效果，回顾该疾病的临床模式、危险因素及治疗方法很有必要。我们回顾性分析了上海第九人民医院五年内诊断并治疗的70例化脓性肝脓肿病例，包括临床特征、治疗方法及治疗效果。平均年龄为63.06±12.33岁。男性占71.4%（50/70）。85.7%（60/70）的患者出现发热症状。实验室主要异常表现为C反应蛋白升高和肝功能障碍。77.8%（14/18）的脓液培养呈阳性，而血培养阳性率为26.5%（9/34）。在血培养（66.7%，6/9）和脓液培养（64.3%，9/14）中，[未提及的病原体名称]均为主要病原体。42.9%（30/70）的患者还患有糖尿病。糖尿病患者的脓肿明显更大（P = 0.014），且更易感染[未提及的病原体名称]（P = 0.002）。我们发现糖化血红蛋白（P = 0.047）、合并恶性肿瘤（P = 0.030）和感染性休克（P = 0.045）是化脓性肝脓肿的三个独立危险因素。总之：化脓性肝脓肿不典型；脓液培养的微生物阳性率高于血培养；[未提及的病原体名称]是化脓性肝脓肿的主要病原体，尤其是在糖尿病患者中；血糖高的患者治疗效果差。
