The clinical features of 93 bacterial liver abscess cases / 中国医师杂志

ABSTRACT

Objective To investigate the clinical features of patients with bacterial liver abscess.Methods The clinical data of patients with liver abscess during January 2014 to December 2016 were retrospectively analyzed.Results There were 93 cases enrolled,26.88％ were accompanied by diabetes mellitus (DM),60.22％ were accompanied liver,gall bladder,pancreas diseases or had history of liver,bile duct or gastrointestinal surgery.The most common symptoms were fever (94.62％) and gastrointestinal symptoms (50.54％),while 15.05％ for shock;91.40％ were single abscess,and 73.12％ were in the right lobe.The white blood cell count (WBC),neutrophil (N),hypersensitive C-reactive protein (hsCRP),procalcitonin (PCT),alanine aminotransferase (ALT),and aspartate aminotransferase (AST) were elevated in 60.22％,65.59％,97.85％,82.93％ (34/41),47.31％,and 46.24％ of patients,respectively.12/62 (19.35％) were positive by blood culture and 32/54 (59.26％) were positive by pyogenic fluids or bile culture,the top two pathogenic bacteria were Klebsiella pneumonia (52.27％) and Escherichia coli (27.27％).Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores were between 0-25 points,72.04％ cases were (0-10) points,26.88％ case were (11-20) points and one patient was more than 20 points.Among the 93 cases,82.79％ were underwent antibacterial by carbapenem,penicillin enzyme compound preparation or combined with levofloxacin,and 45.16％ were underwent liver puncture of drainage treatment.A percentage (96.77％) of patients was cured or recovered.Conclusions Biliary retrograde infection is the main cause of hepatic abscess.In the early experiential antibacterial therapy,the first-line choices of antibiotics are those effective to extended spectrum 3-lactamase (ESBL) positive enterobacteriaceae bacteria.Liver puncture of drainage treatment may be effective and safety.APACHE Ⅱ score may be useful to assess the prognosis of live abscess.