title: Pyogenic liver abscesses with Escherichia coli: etiology, clinical course, outcome, and prognostic factors.
abstract: 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.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Shiuan-Chih
authors.initials: SC
authors.lastname: Chen
authors.forename: Chi-Hua
authors.initials: CH
authors.lastname: Yen
authors.forename: Kuang-Chi
authors.initials: KC
authors.lastname: Lai
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Tsao
authors.forename: Ken-Sheng
authors.initials: KS
authors.lastname: Cheng
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Chen
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lee
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Chou
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents