AI Article Synopsis
- Recent trends show that pyogenic liver abscesses (PLA) are mainly linked to biliary diseases or medical procedures, with a growing prevalence of cases after liver transplants.
- The study analyzed 142 patients from a single hospital and found that 12% experienced recurrence within the first year, while 7.8% died during the study period.
- Key risk factors for these outcomes included the presence of multiresistant organisms, a history of cholangitis, elevated bilirubin levels, and the spread of abscesses across both sides of the liver.
Article Abstract
Background: In times of modern surgery, transplantation and percutaneous techniques, pyogenic liver abscess (PLA) has essentially become a problem of biliary or iatrogenic origin. In the current scenario, diagnostic approach, clinical behavior and therapeutic outcomes have not been profoundly studied. This study analyzes the clinical and microbiological features, diagnostic methods, therapeutic management and predictive factors for recurrence and mortality of first episodes of PLA.
Methods: A retrospective single-center study was conducted including 142 patients admitted to the Hospital Italiano de Buenos Aires, between 2005 and 2015 with first episodes of PLA.
Results: Prevailing identifiable causes were biliary diseases (47.9%) followed by non-biliary percutaneous procedures (NBIPLA, 15.5%). Seventeen patients (12%) were liver recipients. Eleven patients (7.8%) died and 18 patients (13.7%) had recurrence in the first year of follow up. The isolation of multiresistant organisms (p = 0.041) and a history of cholangitis (p < 0.001) were independent risk factors for recurrence. Mortality was associated with serum bilirubin >5 mg/dL (p = 0.022) and bilateral involvement (p = 0.014) in the multivariate analysis.
Conclusion: NBPLA and PLA after transplantation may be increasing among the population of PLA in referral centers. History of cholangitis is a strong predictor for recurrence. Mortality is associated to hiperbilirrubinemia and anatomical distribution of the lesions.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5144545 | PMC |
| http://dx.doi.org/10.1016/j.hpb.2016.09.001 | DOI Listing |
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