title: Clinical and bacteriological characteristics of pyogenic liver abscess in non-diabetic patients.
abstract: OBJECTIVE
  Diabetes mellitus is an important risk factor for Klebsiella pneumoniae liver abscess, but many patients with pyogenic liver abscess (PLA) do not have diabetes. This study was conducted to compare the clinical characteristics and prognostic factors of K. pneumoniae PLA with that caused by other organisms in non-diabetic patients.
  
  
  METHODS
  The medical charts of patients with a diagnosis of PLA were retrospectively reviewed from January 2005 to December 2007. The clinical symptoms and signs, laboratory data, and risk factors were analyzed.
  
  
  RESULTS
  There were 50 patients in the K. pneumoniae group and 34 patients in the non-K. pneumoniae group. The clinical presentations did not differ between the 2 groups. The patients in the non-K. pneumoniae group had a higher prevalence of malignant disease than those in the K. pneumoniae group (58.8% vs 6.0%; p < 0.001). Non-K. pneumoniae PLA was strongly associated with hepatobiliary tumor (p = 0.015). Among the non-K. pneumoniae isolates, Escherichia coli was the most common pathogen (n = 20; 58.8%). Forty seven K. pneumoniae isolates (94%) were susceptible to all tested antimicrobial agents except ampicillin, while the non-K. pneumoniae Gram-negative pathogens had greater resistance to first-generation cephalosporins. Poor prognostic factors included chronic renal failure (p = 0.005), abscess rupture (p = 0.036), and right lower lung infiltration (p = 0.049).
  
  
  CONCLUSIONS
  Hepatobiliary malignancy and newly diagnosed malignancy were risk factors for non-K. pneumoniae liver abscess in non-diabetic patients. Physicians should ascertain the presence of underlying malignancy in patients with non-K. pneumoniae PLA.
authors.affiliation: Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Han-Chuan
authors.initials: HC
authors.lastname: Chuang
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
authors.forename: Dung-Hung
authors.initials: DH
authors.lastname: Chiang
authors.forename: Yi-Tzu
authors.initials: YT
authors.lastname: Lee
authors.forename: Ling-Ju
authors.initials: LJ
authors.lastname: Huang
authors.forename: Fu-Der
authors.initials: FD
authors.lastname: Wang
authors.forename: Chang-Phone
authors.initials: CP
authors.lastname: Fung
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000382:microbiology* / Q000473:pathology*; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000453:epidemiology; D002177:Candidiasis / Q000382:microbiology* / Q000473:pathology*; D005260:Female; D005658:Fungi / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors