Computed tomographic differences of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-Klebsiella pneumoniae.
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.
Kim
Sung-Bum
SB
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea.
Je
Bo-Kyung
BK
Lee
Kee Yeol
KY
Lee
Seung Hwa
SH
Chung
Hwan-Hoon
HH
Cha
Sang Hoon
SH
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