title: Pyogenic Liver Abscess: A Retrospective Study of 105 Cases in an Emergency Department from East China.
abstract: BACKGROUND
  Pyogenic liver abscesses have become common in emergency departments (EDs) in recent years in Shanghai, China due to a variety of risk factors contributory to the disease.
  
  
  OBJECTIVE
  To review our experience in managing pyogenic liver abscesses to aid in the current management of this complex condition.
  
  
  METHODS
  This retrospective study was conducted to collect and analyze information from adult patients diagnosed with liver hepatic abscesses who were admitted to Ren Ji Hospital during the period from January 1, 2010 to December 31, 2015. The demographic data, etiology, underlying diseases, clinical presentation, imaging features, laboratory examinations, microbiological tests, treatment, and clinical outcomes were analyzed.
  
  
  RESULTS
  The data of a total 105 patients were retrospectively analyzed. The mean age of the patients was 62.0 ± 13.5 years. The etiology was predominantly hepatobiliary disease (43/105, 40.1%) or diabetes mellitus (42/105, 40.0%). During hospitalization, 12 patients (11.4%) with septic shock required intensive care. One patient died, yielding a 0.9% fatality rate. In addition to empiric antimicrobial therapy, 66/105 (62.9%) patients underwent ultrasound-guided percutaneous drainage of the liver abscess at diagnosis. Only 3 patients required surgical intervention. Bacterial culture of pyogenic fluids revealed 25 positive results of 66 cases (37.9%). Among them, Klebsiella pneumoniae was the primary pathogen detected in 15 cases (60.0%).
  
  
  CONCLUSIONS
  Pyogenic liver abscesses have become common in EDs in Shanghai, China. The early recognition of the disease, prompt use of empirical antimicrobial therapy, initiation of drainage in the appropriate patients, and controlling the underlying conditions were crucial for preventing severe sepsis and improving the outcome.
authors.affiliation: Department of Emergency Medicine, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Emergency Medicine, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
authors.forename: Wanjun
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
authors.forename: Xiaoye
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Emergency Medicine, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
authors.forename: Keji
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Emergency Medicine, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000032:analysis / Q000097:blood; D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use; D023341:Chills / Q000209:etiology; D002681:China / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005221:Fatigue / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007711:Klebsiella pneumoniae / Q000472:pathogenicity; D007964:Leukocytosis / Q000097:blood / Q000175:diagnosis; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008795:Metronidazole / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D008795:Metronidazole; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: Klebsiella pneumoniae; diabetes mellitus; etiology; pyogenic liver abscesses; treatment