[Clinical features of gas-forming liver abscesses: comparison between diabetic and nondiabetic patients].
OBJECTIVE
Patients with diabetes mellitus (DM) are more likely to have a pyogenic liver abscess with gas formation, which is associated with higher morbidity and mortality. The morbidity and mortality in pyogenic liver abscess are also higher in DM patients than in non-DM patients. This study evaluated the morbidity, mortality, and clinical features in patients with gas-forming liver abscesses associated with DM.


METHODS
Among 379 cases of pyogenic liver abscess excluding malignancy from January 2001 through December 2009, 25 patients treated for pyogenic-gas-forming liver abscesses were reviewed retrospectively. We compared the morbidity, mortality, and clinical findings in patients with pyogenic-gas-forming liver abscesses between DM and non-DM patients.


RESULTS
Gas formation was present in 25 (6.6%) of 379 cases with pyogenic liver abscess. DM was combined with gas-forming liver abscesses in 19 cases (76%). The most common organism responsible for the gas formation was Klebsiella pneumoniae (82%). Complications were present in 23 cases (92%) of gas-forming liver abscesses, with pulmonary complications (especially pleural effusion) being the most common (n=14, 61%). Four patients (16%) died of sepsis.


CONCLUSIONS
Gas-forming liver abscesses are not uncommon in cases of pyogenic liver abscesses and are associated with high morbidity and mortality rates. The clinical manifestations and complications do not differ significantly between DM and non-DM patients.
Lee
Chang Jae
CJ
Department of Internal Medicine, Donga University, College of Medicine, Busan, Korea.
Han
Sang Young
SY
Lee
Sung Wook
SW
Baek
Yang Hyun
YH
Choi
Seok Reyol
SR
Roh
Myung Hwan
MH
Lee
Jong Hoon
JH
Jang
Jin Seok
JS
Han
Jin
J
Cho
Su Hyun
SH
Choi
Se Woong
SW
D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007710:Klebsiella Infections / Q000150:complications; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D007902:Length of Stay; D046290:Liver Abscess, Pyogenic / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents