Epidemiological, Clinical, Microbiological, and Risk Factors of Pyogenic Liver Abscess: An 18-years Retrospective Single-Center Analysis.

Background

A pyogenic liver abscess (PLA) is the most frequently observed subtype of liver abscess in the western world. The disease has been subjected to a remarkable change. We aimed to investigate the recent trend in pyogenic liver abscess's epidemiology, clinical, microbiological, and risk factors features.

Methods

A retrospective analysis of medical records was done for the patients diagnosed with PLA from January 2000 to June 2018. The institutional review board approved the study.

Results

We identified 113 patients with PLA, 60% were males, with a mean age of 54 ± 20 years, and 58 ± 19 years old for males and females, respectively (p = 0.298), with an increasing annual incidence in 2012-2013, and 2016-2017 (Figure 1). Fever and right upper quadrant abdominal pain were the most common symptoms (65%, 55%, respectively). Forty percent of the patients had Biliary tract diseases like cholecystitis or biliary intervention as cholecystectomy or ERCP, and 20% had diabetes mellitus (Table 1). The abscess culture was obtained in 96 cases, 37 cases were negative (39%), 27 cases showed polymicrobial growth (28%) and 15 cases showed Escherichia coli (16%) (Figure 2). The abscess cultures were mostly negative in the first 5 years, then changed to Streptococcus anginosus, and polymicrobial growth in the last four years.

Conclusions

PLA is more common in males with a recent increase in incidence. Culture negative PLA was observed in patients who were empirically treated with antibiotics. Polymicrobial was the most common identifiable organism with a change in the microbiological trend every 5 years.