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Intern Emerg Med 2019 Mar 30. Epub 2019 Mar 30.

College of Medicine, China Medical University, Taichung, Taiwan.

Ann Acad Med Singapore 2019 Feb;48(2):48-54

Division of Infectious Diseases, Changi General Hospital, Singapore.

Introduction: In recent years, () has emerged as the predominant cause of pyogenic liver abscess in Asia. - as the causative microorganism in other visceral organ abscesses-is less described. In this study, we seeked to describe the clinical characteristics of visceral organ abscesses in our institution and evaluated the prescription practices of physicians with regard to antibiotic therapy. Read More

N Z Med J 2019 Mar 29;132(1492):30-35. Epub 2019 Mar 29.

Department of Gastroenterology, Christchurch Hospital, Canterbury District Health Board, Christchurch.

Aims: The determinants, management and outcomes of pyogenic liver abscess [PLA] are changing. We aimed to compare these in a New Zealand cohort.

Methods: We have retrospectively reviewed all PLA cases presenting to Christchurch Hospital over 12 months between 2014 and 2015. Read More

Intern Emerg Med 2019 Mar 7. Epub 2019 Mar 7.

Emergency Medicine Department, National University Hospital, National University Health System, 9 Lower Kent Ridge Road, Level 4, Singapore, 119085, Singapore.

Diagnosing pyogenic liver abscess (PLA) in the emergency department (ED) is challenging due to its non-specific clinical presentation. We aim to identify predictors that aid in diagnosis of PLA in ED patients. This retrospective chart review included patients diagnosed with PLA in a tertiary hospital between January 2008 and December 2012. Read More

BMC Infect Dis 2019 Mar 7;19(1):233. Epub 2019 Mar 7.

National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, Institute of Advanced Surgical Technology and Engineering, First Affiliated Hospital, Xi'an Jiaotong University, 76 West Yanta Road, P.O. Box 124, Xi'an, 710061, Shaanxi Province, China.

Background: Pyogenic liver abscess (PLA) in the elderly is insufficiently elucidated. A few studies attempted to investigate the role of age in PLA have yielded controversial results. The purpose of this study was to explore the possible differences in the comorbidity, microbiological characteristics and clinical course between elderly and young PLA patients. Read More

J Surg Res 2019 Feb 25;239:67-75. Epub 2019 Feb 25.

Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, China. Electronic address:

Background: Pancreaticoduodenectomy (PD) is a complex procedure with a morbidity rate of 40%-50%. We evaluated the incidence, associated factors, etiologic characteristics, and outcome of pyogenic liver abscess (PLA), a rare infectious complication of PD.

Methods: We retrospectively assessed the data of patients who underwent PD (n = 326) between January 2012 and February 2017 at a single institution. Read More

J Med Case Rep 2019 Feb 25;13(1):43. Epub 2019 Feb 25.

Euro-Mediterranean Institute of Science and Technology (IEMEST), Via Emerico Amari, 123, 90139, Palermo, Italy.

Introduction: Hepatic abscess can be defined as an encapsulated collection of suppurative material within the liver parenchyma. Hepatic abscess can be distinguished as pyogenic, amebic, or fungal. Biliary tract disease remains the most common cause of hepatic abscess today, and the most common complications range from pleural effusion, empyema, and bronchohepatic fistula to subphrenic abscess and rupture into the peritoneal cavity, stomach, colon, vena cava, or kidney. Read More

Sci Rep 2019 Jan 31;9(1):1071. Epub 2019 Jan 31.

Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.

Endogenous K. pneumoniae endophthalmitis (EKE) has a higher incidence among East Asians, and the most common infectious source of EKE is pyogenic liver abscess (PLA). We investigate the risk factors for poor visual outcomes in patients with PLA-related EKE. Read More

Pediatr Emerg Care 2019 Feb;35(2):e34-e36

From the Department of Pediatric Emergency Medicine, Cooper University Hospital, Camden, NJ.

Pyogenic hepatic abscess is a rare infection, but it is an important diagnosis to consider because the current mortality is approximately 5%. We present a case of abdominal pain in a 16-year-old male patient whose presentation was initially concerning for appendicitis but was later diagnosed as having a pyogenic hepatic abscess. It is important to direct the patient to the proper treatment including source control with drainage and antibiotics to decrease morbidity and mortality. Read More

QJM 2019 Jan 17. Epub 2019 Jan 17.

Department of Medicine, Department of Surgery, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam.

QJM 2019 Jan 17. Epub 2019 Jan 17.

College of Medicine, China Medical University, Taichung, Taiwan.

Clin Case Rep 2019 Jan 4;7(1):240-241. Epub 2018 Dec 4.

Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Dankook University Hospital Dankook University College of Medicine Cheonan Korea.

Empyema caused by transdiaphragmatic extension of pyogenic liver abscess is a very rare complication of liver abscess. Empyema patients with unclear respiratory symptoms should be evaluated for the presence of underlying liver abscess. Effective drainage with appropriate antibiotic use is an essential part of successful treatment. Read More

BMC Geriatr 2019 Jan 16;19(1):14. Epub 2019 Jan 16.

Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, China.

Background: Geriatric nutritional risk index (GNRI) is a simple and useful nutritional marker for predictor of adverse outcomes in patients undergoing a variety of conditions. This study explored the relationship between GNRI and adverse outcomes of Pyogenic Liver Abscess (PLA) patients and assessed GNRI predictive value.

Methods: This was one retrospective study involving 240 PLA patients. Read More

Pol J Radiol 2018 12;83:e275-e279. Epub 2018 Jun 12.

Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, P.R. China.

Purpose: To compare the treatment efficacy of percutaneous catheter drainage alone to catheter drainage combined with ozone in the management of pyogenic liver abscess (PLA).

Material And Methods: This prospective study included 85 patients diagnosed with PLA. All patients were randomly divided into two groups: catheter drainage alone (Group I); catheter drainage combined with ozone (Group II). Read More

Gut Liver 2019 Mar 15. Epub 2019 Mar 15.

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.

Background/aims: Recurrent pyogenic cholangitis (RPC) is a chronic, progressive disease frequently accompanied by cholangiocarcinoma (CCA). This study aimed to investigate the natural course of RPC and identify factors associated with CCA.

Methods: From January 2005 to December 2016, 310 patients with RPC at Seoul National University Hospital were included. Read More

J Orthop Surg Res 2018 Nov 28;13(1):302. Epub 2018 Nov 28.

Department of Pediatrics, Shimane Prefectural Central Hospital, Izumo, Japan.

Background: Psoas abscess and pyogenic spondylitis are intractable diseases that require long-term treatment, but the clinical characteristics and causative organisms have not been fully investigated. Herein, we describe the clinical characteristics of these diseases and evaluate the factors associated with in-hospital mortality and the presence of gram-negative rods as causative microorganisms.

Methods: All patients diagnosed with pyogenic spondylitis or psoas abscesses at a tertiary hospital were included. Read More

Am J Med Sci 2019 Jan 16;357(1):e3. Epub 2018 Oct 16.

Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, No.2, Zhongzheng 1st Road, Lingya District, Kaohsiung city 80284, Taiwan, ROC. Electronic address:

Intern Med 2019 Mar 19;58(6):889-890. Epub 2018 Nov 19.

Department of Gastroenterology and Hepatology, Kitano Hospital, Japan.

JMM Case Rep 2018 Sep 17;5(9):e005130. Epub 2018 May 17.

Department of Microbiology, Royal Free London NHS Foundation Trust, Royal Free Site, Pond Street, London NW3 2QG, UK.

Introduction: Hypervirulent capsular type K1 strains of clonal complex 23 (CC23) are associated with severe community-acquired pyogenic liver abscesses, often complicated by metastatic infections and significant mortality. The majority of hypervirulent strains reported are susceptible to most antibiotics except ampicillin. To the best of our knowledge, this is the first case of New Delhi metallo-β-lactamase ()-producing hypervirulent from the UK. Read More

ANZ J Surg 2019 Mar 25;89(3):E81-E86. Epub 2018 Oct 25.

Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India.

Background: This prospective randomized comparative study is designed to compare outcomes of ultrasonography-guided pigtail catheter drainage (PCD) and needle aspiration for the treatment of liver abscesses in terms of days to achieve clinical improvement, 50% reduction in cavity size and duration of hospital stay.

Methods: This is a hospital-based comparative study conducted in SMS Hospital, Jaipur, India, from May 2015 to May 2017. Sample size was calculated to be 95 subjects in each of the two groups at α error of 0. Read More

QJM 2018 Oct 16. Epub 2018 Oct 16.

Division of Endocrinology, Department of Medicine, RIPAS Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam.

BMC Gastroenterol 2018 Oct 1;18(1):144. Epub 2018 Oct 1.

Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China.

Background: Pyogenic liver abscess(PLA) has become common in patients with diabetes mellitus (DM), but it is unclear whether differences exist between patients with and without DM. A retrospective study was performed to identify these differences, summarize the clinical experience, and improve the diagnosis and treatment of PLA.

Methods: The patients were enrolled in a teaching hospital from January 2012 to December 2016. Read More

Medicine (Baltimore) 2018 Sep;97(39):e12290

National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine.

Many pyogenic liver abscess (PLA) patients underwent abdominal surgery before. However, little is known about the impact of previous abdominal surgery on the clinical characteristics and prognosis of PLA.The clinical data of 392 adult PLA patients who received treatment at our hospital from January 1, 2007 to December 31, 2016 were collected. Read More

Case Rep Gastrointest Med 2018 4;2018:9509356. Epub 2018 Sep 4.

Department of Gastroenterology, Genesys Regional Medical Center, 1 Genesys Pkwy, Grand Blanc, MI 48439, USA.

Pyogenic liver abscesses (PLA) are an uncommon cause of hospitalization in the United States. The majority of such cases are polymicrobial and are most commonly caused by seeding of infection from the biliary system. PLA is frequently associated with specific comorbidities such as diabetes mellitus, history of liver transplant, underlying hepatobiliary, or pancreatic disease. Read More

BMC Surg 2018 Sep 24;18(1):76. Epub 2018 Sep 24.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan.

Background: We experienced a rare case of benign arterial stricture of the right posterior hepatic artery (RPHA) caused by atherosclerosis in a patient with hilar cholangiocarcinoma.

Case Presentation: A 75-year-old man was referred to our hospital for the detailed investigation of serum hepatobiliary enzyme elevation. The patient had a history of hypertension, type 2 diabetes mellitus, and an operative history of coronary artery bypass grafting 10 years before. Read More

Medicine (Baltimore) 2018 Sep;97(38):e12326

Department of Infectious Diseases, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

This study aimed to analyze the clinical manifestations of patients with pyogenic liver abscess and characteristics of pathogenic that caused their infections, in order to provide guidance for the identification of the pathogens that cause liver abscess and selection of antibiotics for treatment of this disease.In the present study, the clinical characteristics, laboratory results, as well as the species and drug resistance of pathogens in patients with bacterial liver abscesses admitted to our hospital from January 2013 to December 2015 were retrospectively analyzed. The patients were treated by ultrasound or CT-guided percutaneous portal vein catheterization and drainage combined with intravenous infusion of antibiotics (the third-generation cephalosporins, the coformulation of carbapenem and dehydropeptidase-I inhibitors, or the coformulation of tazobactam and piperacillin). Read More

Praxis (Bern 1994) 2018 Sep;107(19):1007-1012

2 Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich.

CME: Fusobacterium nucleatum/naviforme - a Rare but Serious Cause for Pyogenic Liver Abscesses Abstract. Pyogenic liver abscesses belong to the most common abdominal infections. Beside the most common pathogens, also rare forms like Fusobacteria, which can also be part of the natural oropharyngeal and enteral microbiome, may be considered to cause severe forms of abscesses of the liver. Read More

Mayo Clin Proc Innov Qual Outcomes 2018 Mar 22;2(1):16-25. Epub 2018 Feb 22.

Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

Objective: To report the changing incidence, clinical presentation, microbiologic spectrum, and outcomes of pyogenic liver abscess (PLA) in Olmsted County, Minnesota, over the past 35 years.

Patients And Methods: The Rochester Epidemiology Project was used to identify residents with PLA from January 1, 1980, through December 31, 2014. The study included all patients older than 18 years, with the diagnosis of PLA confirmed through radiographic review and microbiologic cultures. Read More

QJM 2019 Feb;112(2):145-146

PAPRSB, Institute of Health Sciences, University Brunei Darussalam, Gadong BE, Brunei Darussalam.

J Infect Dis 2019 Jan;219(4):637-647

Department of Microbiology, National Taiwan University College of Medicine, Taipei.

Background: We previously isolated a Klebsiella pneumoniae strain, NTUH-K2044, from a community-acquired pyogenic liver abscess (PLA) patient. Analysis of the NTUH-K2044 genome revealed that this strain harbors 2 putative type VI secretion system (T6SS)-encoding gene clusters.

Methods: The distribution of T6SS genes in the PLA and intestinal-colonizing K pneumoniae clinical isolates was examined. Read More

Indian J Gastroenterol 2018 07;37(4):378-379

Dr. S N Medical College, Residency Road, Sector-D, Shastri Nagar, Jodhpur, 342 003, India.

Ann Hepatol 2018 Aug;17(5):880-883

Department of Gastroenterology, The affiliated Jurong Hospital of Jiangsu University, Jurong, Jiangsu, P.R. China.

Gastrointestinal foreign bodies are commonly encountered in clinical practice. However, although perforation of the gastrointestinal tract by a foreign body is not unusual, the formation of a hepatic abscess as a result of the migration of a foreign body is extremely rare. Patients usually present with atypical symptoms, and the treatment of such pyogenic liver abscesses presents a challenge. Read More

Am J Trop Med Hyg 2018 Oct;99(4):852-857

Department of Radiodiagnosis, Christian Medical College and Hospital, Vellore, India.

Among pyogenic liver abscesses, melioid etiology is considered in endemic regions in the presence of known health or occupational risk factors. "Honeycomb sign," used to describe an abscess with multiple internal septations dividing the abscess cavity into multiple loculations of comparable sizes on imaging, is a sensitive sign for melioid liver abscess. This is a retrospective case-control study investigating incidence, sensitivity, and specificity of "honeycomb sign" in melioid liver abscess, in a cohort of patients with culture-proven melioidosis infection. Read More

Arq Bras Cir Dig 2018 Aug 16;31(3):e1394. Epub 2018 Aug 16.

Hospital Santa Lucia, Brasília, DF, Brazil.

Background: Percutaneous drainage for pyogenic liver abscess has been considered the gold-standard approach for the treatment on almost of the cases. However, when percutaneous drainage fails or even in some especial situations, as multiloculate abscess, lobe or segment surgical resection can solve infectious clinical condition.

Aim: To report a series of patients who underwent hepatectomy for pyogenic liver abscess performed by a single surgical team. Read More

J Natl Med Assoc 2018 Dec 17;110(6):591-595. Epub 2018 Apr 17.

Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.

Background: Pyogenic liver abscesses (PLAs) are an uncommon, but potentially life threatening infection. We report a case of PLA due to Streptococcus constellatus, a member of the Streptococcus anginosus group (SAG) bacteria, commonly found as commensals of the oropharyngeal, gastrointestinal and genitourinary flora.

Case: The patient, a 42-year-old man with no premorbidities, non-smoker and non-alcoholic, presented to our hospital with high-grade fever associated with chills and rigors and right upper quadrant pain of one month duration. Read More

J Int Med Res 2018 Sep 9;46(9):3824-3836. Epub 2018 Aug 9.

Department of Critical Care Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.

Objective To enhance theoretical support of pyogenic liver abscess (PLA) treatment by comparing characteristics of patients with either PLA with an identified infectious origin (non-cryptogenic) or PLA with no obvious underlying cause (cryptogenic). Methods This retrospective study included all first episodes of PLA in adults admitted to a tertiary hospital between 2009 and 2016. Relevant clinical data were collected for patients with cryptogenic or non-cryptogenic PLA and compared across a number of characteristics. Read More

BMC Infect Dis 2018 Aug 7;18(1):380. Epub 2018 Aug 7.

Department of Infectious Diseases, Barwon Health, Bellarine Street, Geelong, VIC, 3220, Australia.

Background: Hypervirulent strains of Klebsiella pneumoniae are a recognized cause of a distinct invasive syndrome that results in pyogenic liver abscesses and metastatic complications, particularly in the Asia Pacific region. Reports of hypervirulent K.pneumoniae in Europe, the Americas and Australia indicate worldwide spread. Read More

J Infect Chemother 2019 Feb 1;25(2):137-140. Epub 2018 Aug 1.

Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, Saitama, Japan.

A 14-year-old otherwise healthy boy presented with right-sided back pain following high fever. Abdominal computed tomography scan showed a large liver abscess. Klebsiella pneumoniae (KP) was rapidly identified from peripheral blood using the melting temperature mapping (Tm) method, which enables identification of pathogenic microorganisms within four hours after patient sample collection. Read More

Semin Liver Dis 2018 08 24;38(3):270-283. Epub 2018 Jul 24.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Zhejiang University, First Affiliated Hospital, School of Medicine, Hangzhou, China.

Pyogenic liver abscess (PLA) of biliary origin in Southeast Asia mainly occurs in patients with intrahepatic bile duct stone (IBDS) and extrahepatic bile duct stone (EBDS), bilioenteric anastomosis, or biliary stent. IBDS, as an endemic to Southeast Asia, remains a frequent etiology of acute cholangitis and PLA. PLA related to IBDS is characterized by high incidences of PLA recurrence and death related to infection, and difficulties in diagnosis of concomitant cholangicarcinoma. Read More

Pak J Med Sci 2018 May-Jun;34(3):767-769

Dr. Kerem Karaman, Associate Professor, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.

An infected material in the gastrosplenic area after laparoscopic sleeve gastrectomy (LSG) due to hematoma or staple line leak has the potential to spread of the bacterial content to the liver which can result in pyogenic liver abscess. Presently described is a thirty-seven-year-old female patient with unilocular pyogenic liver abscess two weeks after LSG. The abscess resolved by Ultrasound guided percutaneous drainage plus intravenous antibiotic treatment. Read More

Case Reports Hepatol 2018 19;2018:9868701. Epub 2018 Jun 19.

Department of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA, USA.

Liver abscesses are the most common types of visceral abscesses. Pyogenic liver abscesses, a particular type of liver abscesses, are uncommonly encountered. We present a rare case of pyogenic liver abscess caused by methicillin-susceptible in a young man. Read More

Nat Commun 2018 07 13;9(1):2703. Epub 2018 Jul 13.

Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria, 3010, Australia.

Severe liver abscess infections caused by hypervirulent clonal-group CG23 Klebsiella pneumoniae have been increasingly reported since the mid-1980s. Strains typically possess several virulence factors including an integrative, conjugative element ICEKp encoding the siderophore yersiniabactin and genotoxin colibactin. Here we investigate CG23's evolutionary history, showing several deep-branching sublineages associated with distinct ICEKp acquisitions. Read More

Case Rep Med 2018 29;2018:9593865. Epub 2018 May 29.

Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

Liver abscess is a rare but serious complication of Crohn's disease. Patients with Crohn's disease are at risk for pyogenic liver abscesses due to immunosuppressive therapy, fistulous disease, and intraabdominal abscesses. Inflammatory bowel disease patients are also known to have a greater prevalence of amebiasis compared to the rest of the population; however, a higher incidence of amebic liver abscess has not been reported. Read More

Gastroenterology Res 2018 Jun 31;11(3):241-246. Epub 2018 May 31.

Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St Louis, MO, USA.

Pyogenic liver abscesses (PLA) develop from the spread of infection through the portal circulation, biliary infections or arterial hematogenous seeding in the setting of systemic infections. PLA are often poly-microbial and are uncommonly reported to be due to anaerobic species. We report the case of a previously healthy, immunocompetent 63-year-old man with hepatic abscesses as a result of periodontal disease. Read More

Cureus 2018 Mar 20;10(3):e2353. Epub 2018 Mar 20.

Creighton University, Veterans Affairs Omaha.

Hepatic liver abscesses are often misdiagnosed on initial presentation because pyogenic liver lesions are a rare occurrence in the United States. This leads to a delay in proper treatment and results in increasing morbidity and mortality. Our case report demonstrates the atypical presentation of a hepatic liver abscess in the elderly. Read More

J Periodontal Res 2018 Oct 18;53(5):785-792. Epub 2018 May 18.

Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Background And Objectives: The purpose of this study was to investigate the relationship between periodontitis, dental scaling (DS) and pyogenic liver abscesses (PLAs).

Material And Methods: A nationwide population-based case-control study was applied using data from the National Health Insurance Research Database in Taiwan. We identified and enrolled 691 PLA patients, who were individually matched by age and sex to 2764 controls. Read More

Turk J Gastroenterol 2018 03;29(2):241-242

Department of General Surgery, Changhua Show Chwan Memorial Hospital, Changhua, Taiwan.

Medicine (Baltimore) 2018 May;97(19):e0628

Department of Internal Medicine, Santa Croce and Carle Hospital, Cuneo.

Pyogenic liver abscess (PLA) are space-occupying lesions in the liver associated with high morbidity and mortality. The aim of this study is to review an Italian hospital experience in epidemiological, clinical patterns, and management of PLA.We performed a retrospective, descriptive case series at a single center assessing demographic characteristics, presentation patterns, etiological factors, microbiological etiology, and management for patients treated for PLA between 2000 and 2016. Read More

Can J Gastroenterol Hepatol 2018 8;2018:1236974. Epub 2018 Mar 8.

Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China.

Objective: This study was designed to compare the effects of catheter drainage alone and combined with ozone in the management of multiloculated pyogenic liver abscess (PLA).

Methods: The prospective study included 60 patients diagnosed with multiloculated PLA. All patients were randomly divided into two groups: catheter drainage alone (group I) and catheter drainage combined with ozone (group II). Read More