Pyogenic liver abscesses with Escherichia coli: etiology, clinical course, outcome, and prognostic factors.
BACKGROUND
To investigate the clinical characteristics, outcome, and prognostic factors related to mortality in patients with Escherichia coli liver abscess.


METHODS
We retrospectively analyzed 72 patients aged 18 years and older who were diagnosed as having E. coli liver abscesses from July 1996 to June 2002 at two medical centers in Taiwan.


RESULTS
The overall mortality rate was 26.4%. The majority of E. coli liver abscesses was solitary, involved the right lobe of the liver, and comprised polymicrobial infections. The cause of the liver abscess involved the biliary system in 48 patients (66.7%). The most common concomitant diseases were diabetes mellitus (30.6%) and underlying malignancy (30.6%). Metastatic infection was found in 4 patients (5.6%). Multivariate analysis revealed that underlying malignancy (p = 0.034), profound hypoalbuminemia (<2.5 g/dl) (p = 0.008), and multiple abscesses (p = 0.004) were the most significantly prognostic factors for mortality.


CONCLUSIONS
The predominant causes of E. coli liver abscess were biliary diseases. This report also highlights that E. coli liver abscess has a relatively high mortality rate, which is associated with underlying malignancy, multiple abscesses and profound hypoalbuminemia.
Chen
Shiuan-Chih
SC
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Yen
Chi-Hua
CH
Lai
Kuang-Chi
KC
Tsao
Shih-Ming
SM
Cheng
Ken-Sheng
KS
Chen
Chun-Chieh
CC
Lee
Meng-Chih
MC
Chou
Ming-Chih
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D046290:Liver Abscess, Pyogenic / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology
D000900:Anti-Bacterial Agents