Analysis of clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscesses: an insight into risk factors of metastatic infection. (April 2015)

• Record Type: Journal Article
• Authors: Chang, Zhihui; Zheng, Jiahe; Ma, Yujia; Liu, Zhaoyu
• Is Part Of: International journal of infectious diseases. Volume 33(2015:Apr.)
• Page Start: 50
• Page End: 54
• Publication Date: 2015-04
• Subjects: Klebsiella pneumoniae -- Pyogenic liver abscess -- Metastatic infection -- septic pulmonary embolism -- Computed tomography; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2014.12.041
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Unilocular liver abscess is associated with septic pulmonary embolism. Septic pulmonary embolism is associated with extra-pulmonary infection. Diameter of abscess is a predictor of extra-pulmonary metastatic infection. Abstract: Purpose: To compare the clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscess (KPLA), with or without metastatic infection. Materials and Methods: Clinical information (age, sex, clinical symptoms, underlying disease, hematological parameters, abscess-related mortality) and CT characteristics of abscesses were analyzed to investigate associations with metastatic infection. Metastatic infections were divided into septic pulmonary embolism (SPE) and extra-pulmonary metastatic infection (EMI). Results: We identified 66 consecutive patients with KPLA. Metastatic infection occurred in 22/66 patients (33.3%); 8/66 (12.1%) patients had SPE, 6/66 (9.09%) patients had EMI; and 8/66 (12.1%) patients had both SPE and EMI. Patients with SPE were younger than patients without SPE (47.7 ± 13.7 y vs.55.6 ± 12.0 y; p = 0.03). Unilocular abscess was significantly more common in patients with SPE than the non-SPE group (43.75% vs 18.0%, p = 0.036). The mean maximal diameter of EMI was 56.5 ± 21.3 mm and was significantly smaller than that of the non-EMI which was 79.9 ± 31.4 ( p = 0.011). SPE was significantly associated with development of EMI (50% vs17.3%, p = 0.011). Conclusion: Unilocular liver abscess is associated with SPE, and SPE is strongly associated with EMI among patients with KPLA. A maximal diameter of KPLA<55 mm can be used as a predictor of EMI.