title: Computed tomographic differences of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-Klebsiella pneumoniae.
abstract: OBJECTIVE
  To investigate the distinctive computed tomographic(CT) features of pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae (KLA).
  
  
  METHODS
  114 PLA patients (62 men, 52 women, age range 25-89 years, mean age 60.9 years) with positive yield of blood or pus cultures were divided into 2 groups; KLA group (n = 58) and non-KLA group (n = 56). We retrospectively reviewed the CT images. The independent-sample t-test, X2 test, or Fisher's exact test were used with SPSS for windows version 11.0.
  
  
  RESULTS
  Gas formation showed no significant difference between two groups (P = 0.284), but air-fluid pattern was found only in KLA group (P = 0.027). The rim on dynamic CT was showed less frequently in KLA group than non-KLA group (P < 0.001), and smooth and regular rim was more common in non-KLA group (P < 0.001). The septation and septal breakage were more common in KLA group (P < 0.001). The turquoise sign was found significantly more in KLA group (P < 0.001). The hairball sign was detected only in KLA group (P < 0.001). The cluster sign was less frequent in KLA group (P < 0.001).
  
  
  CONCLUSIONS
  KLA had a series of characteristic intra-abscess features; septal breakage, turquoise-like structure, hairball-like content, air-fluid level, and no enhanced rim. When turquoise/hairball sign or air-fluid level is present in abscess, KLA would be a probable diagnosis in the clinical field.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea.
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Kim
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Je
authors.forename: Kee Yeol
authors.initials: KY
authors.lastname: Lee
authors.forename: Seung Hwa
authors.initials: SH
authors.lastname: Lee
authors.forename: Hwan-Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Cha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000000981:diagnostic imaging*; D007711:Klebsiella pneumoniae; D046290:Liver Abscess, Pyogenic / Q000000981:diagnostic imaging* / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed