Thrombocytopenia in Klebsiella pneumoniae liver abscess: a retrospective study on its correlation with disease severity and potential causes.

Objective: Thrombocytopenia is commonly associated with infectious diseases and serves as an indicator of disease severity. However, reports on its manifestation in conjunction with Klebsiella pneumoniae liver abscess (KPLA) are scarce. The present study sought to elucidate the correlation between thrombocytopenia and KPLA severity and delve into the etiological factors contributing to the incidence of thrombocytopenia. Materials and methods: A retrospective analysis of the clinical data from patients with KPLA admitted between June 2012 and June 2023 was performed. Baseline characteristics, biochemical assessments, therapeutic interventions, complications, and clinical outcomes were compared between patients with and without thrombocytopenia. To investigate the potential etiologies underlying thrombocytopenia, the association between platelet count reduction and thrombophlebitis was examined, with a particular focus on platelet consumption. Furthermore, bone marrow aspiration results were evaluated to assess platelet production anomalies. Results: A total of 361 KPLA patients were included in the study, among whom 60 (17%) had concurrent thrombocytopenia. Those in the thrombocytopenia group exhibited significantly higher rates of thrombophlebitis (p = 0.042), extrahepatic metastatic infection (p = 0.01), septic shock (p = 0.024), admissions to the intensive care unit (p = 0.002), and in-hospital mortality (p = 0.045). Multivariate analysis revealed that thrombocytopenia (odds ratio, 2.125; 95% confidence interval, 1.114-4.056; p = 0.022) was independently associated with thrombophlebitis. Among the thrombocytopenic patients, eight underwent bone marrow aspiration, and six (75%) had impaired medullar platelet production. After treatment, 88.6% of thrombocytopenic patients (n = 47) demonstrated recovery in their platelet counts with a median recovery time of five days (interquartile range, 3-6 days). Conclusions: Thrombocytopenia in patients with KPLA is indicative of increased disease severity. The underlying etiologies for thrombocytopenia may include impaired platelet production within the bone marrow and augmented peripheral platelet consumption as evidenced by the presence of thrombophlebitis.

Evaluating the liver abscess microbiota of beef cattle during a reduction in tylosin supplementation shows differences according to abscess size and fraction.

Liver abscesses (LA) resulting from bacterial infection in cattle pose a significant global challenge to the beef and dairy industries. Economic losses from liver discounts at slaughter and reduced animal performance drive the need for effective mitigation strategies. Tylosin phosphate supplementation is widely used to reduce LA occurrence, but concerns over antimicrobial overuse emphasize the urgency to explore alternative approaches. Understanding the microbial ecology of LA is crucial to this, and we hypothesized that a reduced timeframe of tylosin delivery would alter LA microbiomes. We conducted 16S rRNA sequencing to assess severe liver abscess bacteriomes in beef cattle supplemented with in-feed tylosin. Our findings revealed that shortening tylosin supplementation did not notably alter microbial communities. Additionally, our findings highlighted the significance of sample processing methods, showing differing communities in bulk purulent material and the capsule-adhered material. Fusobacterium or Bacteroides ASVs dominated LA, alongside probable opportunistic gut pathogens and other microbes. Moreover, we suggest that liver abscess size correlates with microbial community composition. These insights contribute to our understanding of factors impacting liver abscess microbial ecology and will be valuable in identifying antibiotic alternatives. They underscore the importance of exploring varied approaches to address LA while reducing reliance on in-feed antibiotics.

Prevalence of vascular thrombosis in patients with liver abscess.

Thrombotic complications in liver abscess are less commonly identified in the literature. In this prospective observational study, vascular thrombosis was detected in 21.9% cases. However, there was no significant difference in outcome with or without vascular thrombosis, properly treated.

Effect of continuous in-feed administration of tylosin to feedlot cattle on macrolide and tetracycline resistant enterococci in a randomized field trial.

Liver abscess causes substantial economic loss to the beef cattle industry through liver condemnation, reduced animal performance, and carcass yield. Continuous in-feed use of tylosin is the most effective and a commonly used practice in beef cattle production to prevent liver abscess. However, such mass medication can increase the level of antimicrobial resistant bacteria. We investigated the effect of continuous in-feed use of tylosin in feedlot cattle on (i) concentrations and prevalence of erythromycin-resistant (ERYr) and tetracycline-resistant (TETr) enterococci; (ii) associated antimicrobial resistance genes (ARGs) for resistance; (iii) species distribution; iv) macrolide and tetracycline resistance gene concentrations; and (v) tylosin concentration. A cohort of weaned calves were randomized to receive tylosin-medicated feed (Tylosin; n = 10) or nonmedicated feed (Control; n = 10) for a full feedlot cycle. Feces, feed and pen-surface samples were collected and processed by culture, droplet digital PCR, and liquid chromatography/mass spectroscopy for bacterial enumeration, detection and characterization, ARG quantification, and tylosin concentration, respectively. Data were analyzed by mixed effects linear- or binary-regression models depending on the outcomes. Tylosin administration significantly increased fecal concentration (P < 0.001) and prevalence (P = 0.021) of ERYr enterococci and erm(B) gene concentration (P < 0.001), compared to the control group. Interestingly, tylosin administration significantly reduced (P = 0.037) fecal TETr enterococci concentration compared to the control group, with no significant effect (P = 0.758) on fecal tet(M) concentration. In both treatment groups, enterococci concentrations increased over time, peaking on 174 days in feed before returning to the baseline. ERYr enterococci concentration was significantly (P = 0.012) higher in tylosin medicated feeds, with no significant effect (P = 0.321) on TETr enterococci concentration. Pen-surface concentration of ermB was significantly (P = 0.024) higher in the tylosin group, with no significant effect (P > 0.05) on bacterial concentrations. Increased diversity and a shift in the composition of enterococcal species and ARGs were observed over time, although tylosin use did not significantly affect (P > 0.05) their prevalence. Tylosin concentration was significantly higher in the feces of tylosin administered cattle (P < 0.001) and medicated feed (P = 0.027), with numerically higher pen-surface concentration (P = 0.065) in the tylosin group. In conclusion, continuous in-feed use of tylosin in feedlot cattle increases macrolide resistant enterococci and its fecal excretion, while decreasing tetracycline resistance. Two medically important species, E. faecium and E. faecalis, were predominant regardless of resistance status or sample source. Risk-based approaches including label changes to limit tylosin use such as withdrawal period, and development of effective manure treatments are potential areas of research to reduce environmental and public health impacts.

Hypervirulent Klebsiella Pneumoniae, an Emerging Cause of Endogenous Endophthalmitis in A French Center: A Comparative Cohort Study.

INTRODUCTION: Klebsiella pneumoniae (KP) is the most common cause of endogenous endophthalmitis (EE) in Asia, but data in Europe are scarce. We describe eight cases of KP EE compared to a cohort of EE in a French center. METHODS: EE cases were retrospectively studied between January 2014 and January 2021. KP EE cases were analyzed to assess clinical, microbiological features, and outcome. RESULTS: Among the 33 EE cases identified, the first causative agent (24%, n = 8) was KP, mainly (7/8) with hypervirulent phenotype (hvKP). All but one of these cases occurred from December 2019 to January 2021. Contrary to non-KP patients, KP patients had multiple extraocular infective foci (p = .006), all presented with liver abscesses (p < .001), 50% had cerebral involvement (p = .13). Visual outcome was poor in both groups. CONCLUSION: KP is an emerging cause of EE in a French center, consistently associated with liver abscesses, frequent cerebral involvement, and predominance of hvKP strains.

Liver Abnormalities in Cattle: Effect of Liver Abscessation on Growth and Productivity of Cattle.

Liver abscess has been identified in multiple classes of cattle, but cattle consuming higher energy diets may have greater prevalence of abscessation. The presence and severity of liver abscess has been associated with reduced dry matter intake, daily gain, and gain efficiency of individually fed animals, and as the prevalence of abscesses within pens of animals increases, growth performance worsens. Because of the importance of the liver to metabolism, damage due to abscess could negatively affect energy utilization. A preliminary analysis indicates severe liver abscess incidence increases the requirement of metabolizable energy for maintenance.

Antimicrobial and Biological Methods to Control Liver Abscesses.

Antimicrobial products are approved for the control of liver abscesses with varying amounts of data. When compared to negative controls, tylosin has the most data to support a reduction in total (risk ratio 0.34) and severe A+ (risk ratio 0.31) liver abscesses. Due to the reduction in the use of antimicrobials, vaccination to control liver abscess prevalence is intriguing. However, available vaccines do not appear to be effective in controlling the prevalence of liver abscesses, especially when the disease prevalence is high.

Liver abscesses in the Western pediatric population.

Background and study aims: Liver abscesses are rare in the Western pediatric population and data on predisposing factors and etiology are scarce. We aimed to describe predisposing factors, microbiological characteristics, and treatment. Patients and methods: Retrospective analysis of children admitted to two tertiary care hospitals in Belgium from 1 January 1996 to 31 December 2019. We analyzed clinical features, predisposing factors, imaging characteristics, microbiological data, treatment, and outcome in children with a liver abscess and compared these data with the literature. Results: We collected 24 cases with a male to female ratio of 1.4 and a median age of 3.2 years at time of diagnosis. Survival was 95.8%. Invasive culture specimens were obtained in 83.3% and showed growth of bacteria in 55%. Parenteral antibiotics were administered before invasive culture sampling in 80%. Liver abscesses were cryptogenic in four (16.7%) patients. Hepatobiliary disease was the most prevalent predisposing factor (n = 6; 25%), followed by recent antineoplastic therapy for malignancies (n = 5; 20.8%), intra-abdominal surgical pathology (n = 4; 16.7%) and umbilical venous catheters (n = 2; 8.3%). In two patients there was a parasitic origin (n = 2; 8.3%) and in one it was caused by Bartonellosis. There was no diagnosis of chronic granulomatous disease (CGD) in our cohort. Conclusions: Pediatric liver abscesses have a favorable outcome in the developed world. Whenever feasible, invasive abscess culture specimens should be obtained. In patients presenting with a cryptogenic liver abscess or atypical disease course, immunological workup should be ensured.

Development and validation of a prediction model based on clinical and CT features for invasiveness of K. pneumoniae liver abscess.

OBJECTIVES: Klebsiella pneumoniae liver abscess (KPLA) complicated with extrahepatic migratory infection (EMI) is defined as invasive KPLA. The current study aimed to develop and validate a risk prediction model for the invasiveness of KPLA. METHODS: From 2010 to 2020, KPLA patients from four institutes were selected retrospectively. In the development cohort, risk factors from a logistic regression analysis were utilized to develop the prediction model. External validation was performed using an independent cohort. RESULTS: A total of 382 KPLA patients comprised two separate cohorts: development cohort (institute 1, n = 286) and validation cohort (institute 2-4, n = 86). The overall incidence of EMI was 19.1% (development cohort, n = 55; validation cohort, n = 18, p > 0.05). In the development cohort, four risk factors (age ≤ 40 years, fasting blood glucose (FBG) > 7 mmol/L, no rim enhancement, and thrombophlebitis on CT), significantly associated with EMI, were incorporated into the scoring system. The area under curve (AUC) of the receiver operating characteristic curve (ROC) in the development and validation cohorts was 0.931 (95% confidence interval [CI]: 0.93-0.95) and 0.831 (95% CI: 0.86-0.91), respectively. The calibration curves fitted well. The incidence of EMI was 3.3% and 56.5% for the low- (total scores ≤ 4) and high-risk (total scores > 4) groups in the development cohort, and 3.2% and 66.7% in the validation cohort (all p < 0.001), respectively. CONCLUSIONS: Age ≤ 40 years, FBG > 7 mmol/L, no rim enhancement, and thrombophlebitis were independent risk factors for EMI. This validated prediction model may aid clinicians in identifying KPLA patients at increased risk for invasiveness. KEY POINTS: • Four risk factors are significantly associated with extrahepatic migratory infections (EMI): age ≤ 40 years, fasting blood glucose (FBG) > 7 mmol/L, no rim enhancement, and thrombophlebitis on CT. • Based on these risk factors, the current study developed and validated a prediction model for the invasiveness of Klebsiella pneumoniae liver abscess (KPLA). • This validated prediction model may in the help early identification of KPLA patients at increased risk for invasiveness.

Risk Factors of Septic Metastatic Infection among Patients with Klebsiella pneumoniae Liver Abscess in Singapore: A Case-Control Study.

Metastatic infection resulting from Klebsiella pneumoniae liver abscess (KPLA) results in high mortality and morbidity. This study aimed to determine the risk factors associated with metastatic infection among patients with KPLA in Singapore. A retrospective case-control analysis among adult patients admitted to the National University Hospital with KPLA between 2013 and 2017 was conducted. Univariate and multivariate regression analysis was conducted. Of the 116 KPLA patients, 38.8% had pulmonary metastatic infection. Length of hospital stay (P = 0.001) and intensive care unit admissions (P = 0.044) were significantly longer and greater, respectively, among the patients with metastatic infection. Sepsis-induced hypotension (adjusted odds ratio [AOR], 4.88; 95% CI, 1.1-21.69), breathlessness (AOR, 5.10; 95% CI, 1.42-18.27), and abscess size (AOR, 1.02; 95% CI, 1.01-1.03) were associated independently with septic metastatic infection. Patients with KPLA who had breathlessness and larger abscess size are at a greater risk of septic metastatic infection.

[COMMUNITY ACQUIRED KLEBSIELLA PNEUMONIAE LIVER ABSCESS - REPORT FROM ISRAEL].

INTRODUCTION: Klebsiella pneumoniae is facultative anaerobic bacilli gram-negative bacteria. Klebsiella pneumoniae often causes urinary tract infections and sometimes causes community acquired pneumonia. During the past two decades, a distinct syndrome of Klebsiella pneumoniae with a pyogenic liver abscess was noted. The incidence is higher among patients with diabetes mellitus, and can cause serious complications, including bacteremia, meningitis, endophthalmitis and necrotizing fasciitis. The first cases were reported from Taiwan, but later, more cases emerged in other Asian countries. During recent years the incidence of Klebsiella pneumoniae liver abscess has increased globally, with cases also reported in Australia, New Zealand, West Europe and the United States. To the best of our knowledge, these are the first 2 cases described in Israel.

[COMMUNITY ACQUIRED KLEBSIELLA PNEUMONIAE LIVER ABSCESS - REPORT FROM ISRAEL].

BACKGROUND: Klebsiella pneumoniae is facultative anaerobic bacilli gram-negative bacteria. Klebsiella pneumoniae, often causes urinary tract infections and sometimes causes community acquired pneumonia. During the past two decades, a distinct syndrome of Klebsiella pneumoniae with a pyogenic liver abscess was noted. The incidence is higher among patients with diabetes mellitus, and can cause serious complications, including bacteremia, meningitis, endophthalmitis and necrotizing fasciitis. The first cases were reported from Taiwan, but later, more cases emerged in other Asian countries. During recent years the incidence of Klebsiella pneumoniae liver abscess has increased globally, with cases also reported in Australia, New Zealand, West Europe and the United States. To the best to our knowledge, these are the first 2 cases described in Israel.

Meta-analysis of the effects of essential oil as an alternative to monensin in diets for beef cattle.

Additives used to improve feed efficiency of beef cattle on high-grain diets requires products that not only increase animal performance but also provide food safety for consumers. Since phytogenic additives such as essential oils (EO) are the main substitutes for monensin in the diet of cattle fed high-grain diets, this study aimed to evaluate, through meta-analysis, the effects of EO as an alternative to monensin in diets for beef cattle on feed intake, performance, carcass characteristics and ruminal fermentative parameters. Ten peer-reviewed publications with 27 treatment means were included in the data set. These effects were evaluated using random-effect models to examine the weighted mean differences (WMD) between EO treatment and control treatment (diets with monensin). Heterogeneity was explored by meta-regression and subgroup analysis. The substitution of EO for monensin did not affect methane production, ruminal pH values, average daily gain, feed efficiency or carcass weight. However, carcass dressing percentage (WMD = 0.38%; P = 0.03), ribeye area (WMD = 0.82 cm2; P < 0.0001) and subcutaneous fat thickness (WMD = 0.56 mm; P < 0.0001) values increased. Although the use of EO instead of monensin had no influence on the performance of beef cattle fed high-grain diets, the prevalence of hepatic abscesses increased 84.9% and the replacement of monensin by EO increased the risk ratio of hepatic abscess prevalence by 107%. Therefore, the use of EO in high-grain beef cattle diets was ineffective in protecting the liver against abscesses.

A study on causes of cattle liver condemnation at an abattoir in Omdurman area, Khartoum State, Sudan.

BACKGROUND: Information obtained from abattoirs on the causes of liver condemnation is important in preventing the spread of diseases and for promoting food security. The current study reviews three years (2009 to 2011) postmortem inspection records of cattle slaughtered at an abattoir in Omdurman, Khartoum State, Sudan. The aim was to determine the prevalence of diseases and conditions that lead to liver condemnation. RESULTS: From a total of 234,175 cattle slaughtered, 8,910 (3.8%) livers were condemned due to several diseases/conditions mainly fasciolosis, cysticercosis, necrosis, abscess, calcification, hemorrhages, liver cirrhosis, hydatidosis, and other miscellaneous causes. Collectively, fasciolosis was the leading cause of liver condemnation and was responsible for 51.6 % of total liver condemnations followed by necrosis (18.6%), and cysticercosis (13.5%). CONCLUSIONS: Because of their zoonotic nature, the observed high frequency of some detected diseases/conditions is thought to pose a public health risk among consumers. This survey could be used as a regional baseline for future monitoring of control programmers against these liver diseases.

Association between prophylactic antibiotic use for transarterial chemoembolization and occurrence of liver abscess: a retrospective cohort study.

OBJECTIVES: Clinical evidence on prophylactic antibiotics for transarterial chemoembolization (TACE) to prevent liver abscess is limited because liver abscess is a rare event. This study aimed to analyse the association between prophylactic antibiotic use for TACE and the occurrence of liver abscess after TACE. METHODS: Using the nationwide Diagnosis Procedure Combination database in Japan, we retrospectively identified patients who underwent TACE for hepatic cancer between July 2010 and March 2017. The primary outcome was liver abscess requiring procedural intervention within 30 days of TACE. Secondary outcomes included 30-day in-hospital mortality and length of stay. Propensity score matching was performed to adjust for potential confounding factors and compare outcomes between patients with and without prophylactic antibiotics. RESULTS: Among 167 544 eligible patients, 134 712 received antibiotics and 32 832 did not. In the matched cohort of 29 211 pairs, the proportion of patients with liver abscess requiring procedural intervention was significantly lower in the antibiotics group than in the no-antibiotics group (0.08% vs. 0.22%, p 0.001; relative risk (95% confidence interval), 0.35 (0.22-0.57); absolute risk reduction, 0.0014 (0.0008-0.0021); and number needed to treat, 696 (476-1223)). There was no significant difference in 30-day in-hospital mortality between the groups. The length of stay was longer in the antibiotics group than in the no-antibiotics group (median, 10 vs. 9 days, p < 0.001). CONCLUSIONS: Prophylactic antibiotic use in patients undergoing TACE was associated with a reduced occurrence of liver abscess requiring procedural intervention.

Liver Abscess in Chronic Granulomatous Disease-Two Decades of Experience from a Tertiary Care Centre in North-West India.

PURPOSE: Most of the literature on liver abscess in chronic granulomatous disease (CGD) emanates from developed countries. Data from developing countries are scarce. In this study, we report clinical features, microbiological profile, and treatment difficulties encountered while managing liver abscesses in patients with CGD at a tertiary care centre in North-West India. METHODOLOGY: Case records of children with CGD and liver abscesses at Pediatric Immunodeficiency Clinic, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India were analyzed. RESULTS: Seven of 68 patients (10.29%) with CGD presented with hepatic abscess. One patient had 2 recurrences. All were males and age-range at presentation was 7 months-22 years. Mutation analysis was carried out in all patients-3 had defects in CYBB gene; 2 in NCF1; 2 in NCF2 gene. Staphylococcus aureus was isolated from 5 patients. Duration of antimicrobial treatment ranged from 3 weeks to 7 months. Open drainage was required in 1 patient, and 1 patient was treated with a prolonged course of prednisolone. Two children succumbed to the illness. CONCLUSIONS: This is the largest reported experience of liver abscesses in patients with CGD from the developing world. Staphylococcus aureus was the commonest pathogen isolated. In our experience, prolonged courses of antimicrobials are usually necessary in these patients. Glucocorticoids can reduce inflammatory response and facilitate early resolution of abscesses in CGD.

Síndrome de absceso hepático invasor por Klebsiella pneumoniae, serie de casos / Invasive liver abscess syndrome caused by Klebsiella pneumoniae, case series

Resumen Introducción: Los abscesos hepáticos primarios producidos por Klebsiella pneumoniae y las implicancias sistémicas relacionadas constituyen el síndrome de absceso hepático invasor por Klebsiella pneumoniae. Objetivo: Describir las características clínicas, epidemiológicas y la evolución de esta entidad en nuestro centro. Pacientes y Métodos: Cohorte retrospectiva de pacientes adultos internados en el Hospital Italiano de Buenos aires entre el 1 de enero de 2001 y el 1 de mayo de 2020. Se incluyeron pacientes con diagnóstico de absceso en cualquier órgano con aislamiento en cultivo de absceso o hemocultivo positivo para Klebsiella pneumoniae para ser analizadas las características epidemiológicas, clínicas y la evolución de aquellos con localización primaria hepática. Resultados: 10 pacientes fueron incluidos. Dos (20%) pacientes fueron orientales. La mediana de edad fue 69 años (IIC 64-79), nueve (90%) fueron hombres. La co-morbilidad más frecuente fue diabetes mellitus tipo 2 (40%). Cuatro (40%) pacientes tuvieron diseminación a otros órganos. La mediana de internación fue 21,5 días (IIC 15-43), 60% (n: 6) requirió internación en unidad de cuidados intensivos y 30% (n: 3) de los pacientes falleció. Conclusión: El síndrome de absceso hepático invasor por Klebsiella pneumoniae es una enfermedad infrecuente, potencialmente mortal. Este estudio intenta reportar las características de los pacientes con esta patología en nuestra población.

Abstract Background: Primary liver abscesses caused by Klebsiella pneumoniae and their related systemic complications produce the invasive liver abscess syndrome due to Klebsiella pneumoniae. Aim: To describe the clinical, epidemiological and evolution characteristics in our center. Methods: A retrospective cohort of hospitalized adults in Hospital Italiano de Buenos Aires between January 1st, 2001 and May 1st, 2020. We included patients with diagnosis of abscess in any organ with rescue in culture or positive blood culture for Klebsiella pneumoniae. Epidemiological, clinical characteristics and prognosis of those with hepatic primary localization were analyzed. Results: 10 patients were included. Two (20%) patients were Oriental. Median age was 69 years (interquartile range 64-79), nine (90%) were men. The most frequent comorbidity was type 2 diabetes (40%). Four (40%) patients had spread to other organs. The median hospitalization was 21.5 days (IIC 15-43), 60% (n: 6) were hospitalized in the intensive care unit and 30% (n: 3) died. Conclusions: The invasive liver abscess syndrome due to Klebsiella pneumoniae is a rare life-threatening disease. Our study reports the characteristics of patients with this syndrome in our population.

Detection of spleen abscesses facilitates diagnosis of melioidosis in Malaysian children.

OBJECTIVES: Melioidosis is associated with extremely high case fatality ratios. The aim of this study was to determine whether detection of abdominal visceral abscesses can facilitate diagnosis of melioidosis in children. METHODS: We conducted a retrospective analysis of all children who had liver and/or spleen abscesses on abdominal ultrasonography admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2014 until December 2018. RESULTS: Fifty-three children had liver and/or spleen abscesses. Spleen abscesses were present in 48 (91%) cases; liver abscesses in 15 (28%). Melioidosis was confirmed by culture in 9 (17%) children; small occult splenic abscesses were present in all cases. In 78% of these cases, the lesions were detected before any positive culture (or serology) results were available. Four (8%) children had bacteriologically-confirmed tuberculosis. Two (4%) had Staphylococcus aureus infection. Of the remaining 38 (72%) culture-negative cases, 36 (95%) had clinical and imaging characteristics similar to that of children with culture-confirmed melioidosis and improved with empirical melioidosis antibiotic therapy. CONCLUSIONS: A large number of children in Bintulu Hospital in Sarawak, Malaysia, were found to have spleen abscesses. Melioidosis was the most common etiology identified in these children. Abdominal ultrasonography is extremely useful in facilitating the diagnosis of pediatric melioidosis.

[Invasive liver abscess syndrome caused by Klebsiella pneumoniae, case series]. / Síndrome de absceso hepático invasor por Klebsiella pneumoniae, serie de casos.

BACKGROUND: Primary liver abscesses caused by Klebsiella pneumoniae and their related systemic complications produce the invasive liver abscess syndrome due to Klebsiella pneumoniae. AIM: To describe the clinical, epidemiological and evolution characteristics in our center. METHODS: A retrospective cohort of hospitalized adults in Hospital Italiano de Buenos Aires between January 1st, 2001 and May 1st, 2020. We included patients with diagnosis of abscess in any organ with rescue in culture or positive blood culture for Klebsiella pneumoniae. Epidemiological, clinical characteristics and prognosis of those with hepatic primary localization were analyzed. RESULTS: 10 patients were included. Two (20%) patients were Oriental. Median age was 69 years (interquartile range 64-79), nine (90%) were men. The most frequent comorbidity was type 2 diabetes (40%). Four (40%) patients had spread to other organs. The median hospitalization was 21.5 days (IIC 15-43), 60% (n: 6) were hospitalized in the intensive care unit and 30% (n: 3) died. CONCLUSIONS: The invasive liver abscess syndrome due to Klebsiella pneumoniae is a rare life-threatening disease. Our study reports the characteristics of patients with this syndrome in our population.

Case Report: First Molecular Diagnosis of Liver Abscesses Due to Fasciola hepatica Acute Infection Imported from Vietnam.

We report a case of Fasciola hepatica liver abscesses in a 67-year-old female returning from a trip to Vietnam. She has been suffering from a fever, right abdominal pain for 4 days, and major eosinophilia. Radiologic investigations showed multiple hypodense confluent abscesses in the right lobe of the liver, complicated by occlusive thrombosis of the right branch of the portal vein. The serological investigation of helminth-elicited eosinophilia showed only a positive serology for F. hepatica. Despite repeated negative stool examinations for any intestinal pathogen, the diagnosis was established by the detection of F. hepatica DNA in stool and pus aspirate samples.