Clinical and pathogenic characteristics in 75 patients with pyogenic liver abscess

Objective To analyze the clinical and pathogenic characteristics, susceptible factors and treatment efficacy of the patients with pyogenic liver abscess retrospectively, so as to provide evidence for the diagnosis and treatment of pyogenic liver abscess. Methods A total of 75 patients with pyogenic liver abscess treated in two infectious diseases hospitals in Beijing from Jan.2010 to Dec. 2013 were enrolled in the study. The clinical data and pathogenic characteristics were analyzed, and risk factors and treatment efficacy of pyogenic liver abscess were investigated. Results Of 75 patients with pyogenic liver abscess, 55 were males and 20 were females, and the average age was 51.9±16.0 years old. The major clinical manifestations were fever(52.00%) and abdominal pain(30.67%). Seventy-two(96.00%) patients suffered from underlying liver disease, 45(62.50%) with liver cirrhosis, 23(31.94%) with liver cancer, 3(4.17%) with alcoholic liver disease and 1(1.39%) with fatty liver. Forty-two(56.00%) patients were complicated by other diseases, 24(57.14%) with peritonitis, 13(30.95%) with AIDS, 11(26.19%) with diabetes and 10(23.81%) with hypertension. The positive rates of bacteria culture were 46.51% in pyogenic fluids and 24.39% in blood. The most frequent pathogen was Klebsiella pneumonia, accounting for 53.33%. Forty-five patients received both ultrasound B or CT-guided percutaneous drainage and antibiotic therapy, with the effectiveness rate of 88.89%. Conclusions Pyogenic liver abscesses mainly occurs in elderly male patients with underlying liver diseases, and has nonspecific clinical manifestations. Klebsiella pneumonia is the most common pathogen. The combination of ultrasound B or CT-guided percutaneous drainage and antibiotic therapy achieves good efficacy.