Wang Xue-Li, Liu Quan-Bo
Department of Infection, Children's Hospital Affiliated to Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Mar 15;27(3):328-333. doi: 10.7499/j.issn.1008-8830.2410025.
To study the clinical characteristics and risk factors of pyogenic liver abscess complicated by sepsis in children.
A retrospective analysis was conducted on the clinical data of 120 children with pyogenic liver abscess admitted from May 2004 to January 2024. According to the presence of sepsis, the children were divided into a sepsis group (82 cases) and a non-sepsis group (38 cases). The clinical characteristics of the two groups were compared, and risk factors associated with the occurrence of sepsis were identified.
Among the 120 children with pyogenic liver abscess, 68.3% (82/120) had sepsis. Multivariate logistic regression analysis showed that fever, elevated white blood cell count, and decreased albumin level were closely associated with the occurrence of sepsis (<0.05). Receiver operating characteristic curve analysis indicated that white blood cell count and albumin levels had significant predictive value for sepsis (<0.05), and the combination of white blood cell count and albumin level showed higher predictive value for sepsis than the albumin level alone (<0.05).
The clinical manifestations of children with pyogenic liver abscess complicated by sepsis are non-specific. Fever, elevated white blood cell count, and decreased albumin level are risk factors for sepsis in children with pyogenic liver abscess. Clinically, for children with unexplained fever and imaging suggestive of liver abscess, pyogenic liver abscess should be considered. If laboratory tests show elevated white blood cell count and decreased albumin level simultaneously, there should be a high level of suspicion for the development of sepsis.
研究儿童化脓性肝脓肿并发脓毒症的临床特征及危险因素。
对2004年5月至2024年1月收治的120例儿童化脓性肝脓肿的临床资料进行回顾性分析。根据是否存在脓毒症，将患儿分为脓毒症组（82例）和非脓毒症组（38例）。比较两组的临床特征，确定与脓毒症发生相关的危险因素。
120例儿童化脓性肝脓肿中，68.3%（82/120）发生脓毒症。多因素logistic回归分析显示，发热、白细胞计数升高及白蛋白水平降低与脓毒症的发生密切相关（<0.05）。受试者工作特征曲线分析表明，白细胞计数和白蛋白水平对脓毒症有显著预测价值（<0.05），白细胞计数与白蛋白水平联合对脓毒症的预测价值高于单独白蛋白水平（<0.05）。
儿童化脓性肝脓肿并发脓毒症的临床表现不具有特异性。发热、白细胞计数升高及白蛋白水平降低是儿童化脓性肝脓肿发生脓毒症的危险因素。临床上，对于不明原因发热且影像学提示肝脓肿的患儿，应考虑化脓性肝脓肿。若实验室检查同时显示白细胞计数升高和白蛋白水平降低，则应高度怀疑发生脓毒症。
