title: Analysis of clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscesses: an insight into risk factors of metastatic infection.
abstract: OBJECTIVE
  To compare the clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscess (KPLA), with or without metastatic infection.
  
  
  METHODS
  Clinical information (age, sex, clinical symptoms, underlying disease, hematological parameters, abscess-related mortality) and CT characteristics of abscesses were analyzed to investigate associations with metastatic infection. Metastatic infections were divided into septic pulmonary embolism (SPE) and extra-pulmonary metastatic infection (EMI).
  
  
  RESULTS
  We identified 66 consecutive patients with KPLA. Metastatic infection occurred in 22/66 patients (33.3%); 8/66 (12.1%) patients had SPE, 6/66 (9.09%) patients had EMI; and 8/66 (12.1%) patients had both SPE and EMI. Patients with SPE were younger than patients without SPE (47.7±13.7 y vs.55.6±12.0 y; p=0.03). Unilocular abscess was significantly more common in patients with SPE than the non-SPE group (43.75% vs 18.0%, p=0.036). The mean maximal diameter of EMI was 56.5±21.3 mm and was significantly smaller than that of the non-EMI which was 79.9±31.4 (p=0.011). SPE was significantly associated with development of EMI (50% vs 17.3%, p=0.011).
  
  
  CONCLUSIONS
  Unilocular liver abscess is associated with SPE, and SPE is strongly associated with EMI among patients with KPLA. A maximal diameter of KPLA<55 mm can be used as a predictor of EMI.
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Chang
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
authors.forename: Jiahe
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
authors.forename: Yujia
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China. Electronic address: liuzy1226@126.com.
authors.forename: Zhaoyu
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000000981:diagnostic imaging*; D007711:Klebsiella pneumoniae; D008100:Liver Abscess / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000382:microbiology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Klebsiella pneumoniae; Metastatic infection; Pyogenic liver abscess; septic pulmonary embolism