Severe Infection
Clinical characteristics of invasive Klebsiella pneumoniae liver abscess syndrome
Ma Yong, Sun Dongyue, Du Chang, Gao Weibo, Zhu Jihong, Chi Cheng
Published 2024-04-10
Cite as Chin J Emerg Med, 2024, 33(4): 485-489. DOI: 10.3760/cma.j.issn.1671-0282.2024.04.006
Abstract
ObjectiveTo analyze the clinical characteristics of invasive klebsiella pneumoniae liver abscess syndrome (IKPLAS), and compare it with common pyogenic liver abscess (CPLA).
MethodsThe social demography and clinical data of inpatients with pyogenic liver abscess from January 2011 to December 2021 in the Peking University People's Hospital were collected. Based on the presence or absence of invasive infections and the results of bacterial etiology, IKPLAS was diagnosed and compared with CPLA. The general information, symptoms, past medical history, auxiliary examinations and prognosis indicators of the two groups of patients were compared.
ResultsTotal of 172 patients with pyogenic liver abscess were collected, including 25 cases of IKPLAS. Compared with CPLA group, the proportion of fever in IKPLAS group was lower, the proportion of diabetes history was higher, the proportion of monocytes was lower, and procalcitonin and urea nitrogen were higher(all P<0.05), the proportion of multiple abscesses is higher, and the positive rate of blood culture and the cultivation of klebsiella pneumoniae are both higher (all P<0.05).A total of 9 cases (5.2%) of patients developed septic shock, of which 2 cases (1.2%) died. The IKPLAS group had a higher proportion of ICU admissions (P<0.05),but but the difference of mortality between the two groups was not statistically significant (P>0.05). The most common sites of invasion infection in the IKPLAS group are the lungs(22/25), brain(9/25), and eyes(9/25).
ConclusionsThere are differences in clinical characteristics between IKPLAS and CPLA, the most common sites of invasion infection are the lungs, brain, and eyes, but there is no difference in mortality in this study. For PLA with pathogenic Klebsiella pneumoniae, it is necessary to carefully evaluate the presence of invasive lesions and provide targeted local treatment to better improve prognosis.
Key words:
Klebsiella pneumoniae; Liver abscess; Invasive syndrome; Hypervirulent klebsiella pneumoniae; Invasive lesions; Endophthalmitis; Prognosis; Mortality
Contributor Information
Ma Yong
Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China
Sun Dongyue
Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China
Du Chang
Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China
Gao Weibo
Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China
Zhu Jihong
Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China
Chi Cheng
Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China