Details

Autor(en) / Beteiligte

• Vishal G Shelat Qiao Wang Clement LK Chia Zhongkai Wang Jee Keem Low Winston WL Woon

Titel

Patients with culture negative pyogenic liver abscess have the same outcomes compared to those withKlebsiella pneumoniae pyogenic liver abscess

Ist Teil von

• 国际肝胆胰疾病杂志（英文版）, 2016, Vol.15 (5), p.504-511

Ort / Verlag

Department of General Surgery, Tan Tock Seng Hos-pital, Singapore 308433, Singapore%Ministry of Health Holdings Pte Ltd., Singapore 099253, Singapore

Erscheinungsjahr

2016

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• BACKGROUND: Etiologic organism is not frequently isolated despite multiple blood and lfuid cultures during management of pyogenic liver abscess (PLA). Such culture negative pyogen-ic liver abscess (CNPLA) is routinely managed by antibiotics targeted toKlebsiella pneumoniae. In this study, we evaluated the outcomes of such clinical practice. METHODS: All the patients with CNPLA andKlebsiella pneu-moniaePLA (KPPLA) admitted from January 2003 to Decem-ber 2011 were included in the study. A retrospective review of medical records was performed and demographic, clinical and outcome data were collected. RESULTS: A total of 528 patients were treated as CNPLA or KPPLA over the study period. CNPLA presented more com-monly with abdominal pain (P=0.024). KPPLA was more com-mon in older age (P=0.029) and was associated with thrombo-cytopenia (P=0.001), elevated creatinine (P=0.002), bilirubin (P=0.001), alanine aminotransferase (P=0.006) and C-reactive protein level (P=0.036). CNPLA patients tend to have anemia (P=0.015) and smaller abscess (P=0.008). There was no differ-ence in hospital stay (15.7 vs 16.8 days) or mortality (14.0% vs 11.0%). No patients required surgical drainage after initiation of medical therapy. CONCLUSION: Despite demographic and clinical differences between CNPLA and KPPLA, overall outcomes are not different.