title: Characteristics of pyogenic liver abscess patients with and without diabetes mellitus.
abstract: OBJECTIVE
  Pyogenic liver abscess (PLA) is relatively common in patients with diabetes mellitus (DM), but it is unclear whether there are differences between patients with and without DM. We conducted a study to identify the possible differences and factors that affect fatality.
  
  
  METHODS
  We included PLA patients treated at a medical center from April 2001 to March 2004 and compared the clinical characteristics of patients with and without DM. We applied chi-square, Fisher's exact, and t-tests to evaluate the differences between the two groups and used logistic regressions to identify predictors of fatality.
  
  
  RESULTS
  Of the 377 patients included, 182 (48.3%) had DM. Patients with DM had higher prevalence rates of cryptogenic etiology, gas-forming nature, thrombocytopenia, hyperglycemia, growth of Klebsiella pneumonia in blood cultures, metastatic infection, and bacteremia, but lower prevalence rates of biliary origin, right upper quadrant pain, and growth of Escherichia coli in pus cultures. Whereas creatinine >1.3 mg/dl (adjusted odds ratio (OR) 7.3, 95% confidence interval (CI) 2.2-24.5) and gas-forming nature (adjusted OR 9.4, 95% CI 3.0-24.5) were predictors of fatality, DM was not. We discovered that C-reactive protein and neutrophil were good biomarkers of PLA, but not asparate aminotransferase and alanine aminotransferase.
  
  
  CONCLUSIONS
  PLA patients with and without DM have different clinical characteristics, but DM is not a predictor of fatality. We have identified several biomarkers that might help reduce the misdiagnosis of PLA.
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Ning-Ping
authors.initials: NP
authors.lastname: Foo
authors.forename: Kuo-Tai
authors.initials: KT
authors.lastname: Chen
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan