Characteristics of pyogenic liver abscess patients with and without diabetes mellitus.
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.
Foo
Ning-Ping
NP
Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
Chen
Kuo-Tai
KT
Lin
Hung-Jung
HJ
Guo
How-Ran
HR
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