Korean J Gastroenterol.  2016 May;67(5):245-252. 10.4166/kjg.2016.67.5.245.

Septic Shock in Pyogenic Liver Abscess: Clinical Considerations

• Cho AR
• Lee TH
• Park MJ
• Oh SH
• Lee JA
• Park JH
• Ryu KH
• Koo HS
• Song KH
• Kim SM
• Huh KC
• Choi YW
• Kang YW

• KMID: 2164331
• DOI: http://doi.org/10.4166/kjg.2016.67.5.245

Abstract

BACKGROUND/AIMS
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-forming 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.

Keyword

Pyogenic liver abscess; Septic shock; Mortality; APACHE II; Klebsiella pneumoniae

MeSH Terms

Abscess
APACHE
Blood Platelets
Creatinine
Humans
Klebsiella pneumoniae
Liver Abscess, Pyogenic*
Medical Records
Mortality
Multivariate Analysis
Pneumonia
Risk Factors
Shock, Septic*
Creatinine

Reference

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