Demographics and Clinical Outcomes of Culture-Positive versus Culture-Negative Pyogenic Liver Abscess in an Asian Population.

OBJECTIVE

Despite its high case-fatality risk, pyogenic liver abscess (PLA) lacks clear management guidelines in patients with negative microbial cultures. Our aim was to evaluate differences in clinical characteristics between patients with culture-negative liver abscess (CNLA) and those with culture-positive liver abscess (CPLA), and identify differences in the main causative pathogen.

METHODS

In this study, we retrospectively collected medical records of PLA patients admitted to a teaching hospital from January 2010 to December 2019.

RESULTS

In total, 324 PLA patients were enrolled in this study. Of these, 202 (62.3%) cases were confirmed cultural positive, including 109 patients (54%) and 20 (9.9%) patients infected with () and (), respectively. Patients in the CPLA group were older (=0.029) and had higher prevalence of abscesses larger than 5 cm in diameter ( = 0.003), gas-forming rate ( = 0.016), and percutaneous drainage ( < 0.001) compared with CNLA group. Patients with CPLA had significantly longer hospitalizations than those with CNLA ( = 0.010). Nevertheless, there was no significant difference in in-hospital mortality between the two groups ( = 0.415). Compared with patients with , those with had higher incidence of diabetes mellitus ( = 0.041), solitary abscess ( < 0.001), localization in the right hepatic lobe ( = 0.033), abscess size larger than 5 cm ( < 0.001) and percutaneous drainage ( = 0.002), but mortality was not significantly different ( = 1.000).

CONCLUSION

No significant difference in in-hospital mortality was found between patients with CNLA and those with CPLA group. However, clinical characteristics and management were different between the main causative pathogens, including and .