title: [Septic Shock in Pyogenic Liver Abscess: Clinical Considerations].
abstract: OBJECTIVE
  Pyogenic liver abscess (PLA) is a life-threatening condition, despite advances in diagnostic technology and strategies for treatment. A strong predictor of mortality in this condition is septic shock. This study describes clinical, biochemical, and radiologic features in patients with PLA with or without septic shock, with the intent of describing risk factors for septic shock.
  
  
  METHODS
  Of 358 patients with PLA enrolled, 30 suffered septic shock and the remaining 328 did not. We reviewed the medical records including etiologies, underlying diseases, laboratory, radiologic and microbiologic findings, methods of treatment and treatment outcomes.
  
  
  RESULTS
  The case fatality rate was 6.1%. In univariate analysis, the presence of general weakness, mental change, low platelet level, prolonged PT, high BUN level, high creatinine level, low albumin level, high AST level, high CRP level, abscess size >6 cm, the presence of gas-forming abscess, APACHE II score ≥ 20, and the presence of Klebsiella pneumoniae infection were significantly associated with septic shock. Multivariate analysis showed the presence of mental change (p=0.004), gas-form -ing abscess (p=0.012), and K. pneumoniae infection (p=0.027) were independent predictors for septic shock.
  
  
  CONCLUSIONS
  The presence of mental change, gas-forming abscess, and K. pneumoniae infection were independent predictors for septic shock in patients with PLA.
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: A Reum
authors.initials: AR
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Joo Ah
authors.initials: JA
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Joo Ho
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Ki Hyun
authors.initials: KH
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Hoon Sup
authors.initials: HS
authors.lastname: Koo
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Sun Moon
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Kyu Chan
authors.initials: KC
authors.lastname: Huh
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Young Woo
authors.initials: YW
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Young Woo
authors.initials: YW
authors.lastname: Kang
mesh_terms: D018806:APACHE; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications / Q000175:diagnosis; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D007902:Length of Stay; D046290:Liver Abscess, Pyogenic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012772:Shock, Septic / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: APACHE II; Klebsiella pneumoniae; Mortality; Pyogenic liver abscess; Septic shock