Pyogenic liver abscesses caused by Klebsiella pneumoniae:: US appearance and aspiration findings
Pyogenic liver abscesses caused by Klebsiella pneumoniae:: US appearance and aspiration findings
复制标题
DOI：
10.1148/radiol.2423051344
复制
发表时间：
2007-03-01
期刊：
影响因子：
19.7
通讯作者：
Woo, Patrick C. Y.
中科院分区：
文献类型：
--
作者：
Hui, Joyce Y. H.;Yang, Michael K. W.;Woo, Patrick C. Y.
目的：回顾性比较肺炎克雷伯菌引起的肝脓肿与其他病原菌引起的肝脓肿的超声表现和初吸脓量。材料和方法：本研究已获得医学伦理委员会批准；不需要知情同意。研究对象包括5年内发生化脓性肝脓肿的亚洲患者。分析脓肿的临床、实验室和微生物学特征、治疗和结果。根据最大肝脓肿的大小、病变的回声模式、病变内是否存在任何回声碎片、病变后部传播增加以及病变边缘进行超声图像分类。比较肺炎克氏菌单微生物性肝脓肿患者与非肺炎克氏菌单微生物性或多微生物性肝脓肿患者的临床和美国特征。分类变量采用chi(2)或Fisher精确检验；对连续变量采用Student t检验。结果：120例化脓性肝脓肿。患者年龄中位数为69岁（范围13-94岁）。男性59例，女性61例。50例单微生物肺炎克雷伯菌肝脓肿患者和33例非单微生物肺炎克雷伯菌或多微生物肝脓肿患者行超声检查。肺炎克氏菌单菌性肝脓肿与糖尿病（P < 0.001）、入院时较高的血糖水平（P < 0.05）、主要为实性美国征状（P < 0.001）、病灶边缘不规则或模糊（P < 0.05）、抽脓量小于2 mL （P < 0.001）和抗生素治疗持续时间较长（P < 0.05）相关。结论：US的实性表现主要与肺炎克氏菌单菌性肝脓肿有关。肺炎克氏菌肝脓肿与初次吸入脓量少得多有关。
Purpose: To retrospectively compare the ultrasonographic ( US) appearance and amount of pus obtained at initial aspiration for liver abscesses caused by Klebsiella pneumoniae with those for liver abscesses caused by other bacterial pathogens.Materials and Methods: This study had medical ethics committee approval; informed consent was not required. Asian patients with pyogenic liver abscesses in a 5-year period were included. Abscess clinical, laboratory, and microbiologic characteristics and treatment and outcome were analyzed. US images were classified according to the size of the largest liver abscess, the echogenic pattern of the lesion, the presence of any echogenic debris within the lesion, increased through transmission in the posterior aspect of the lesion, and the lesion margin. Clinical and US characteristics of patients with K pneumoniae monomicrobial liver abscesses and those with non-K pneumoniae monomicrobial or polymicrobial liver abscesses were compared. The chi(2) or Fisher exact test was used for categorical variables; the Student t test was used for continuous variables.Results: There were 120 patients with pyogenic liver abscesses. Median patient age was 69 years ( range, 13-94 years). Fifty-nine patients were male, and 61 were female. Fifty patients with K pneumoniae monomicrobial and 33 patients with non-K pneumoniae monomicrobial or polymicrobial liver abscesses underwent US. K pneumoniae monomicrobial liver abscesses were associated with diabetes mellitus ( P < .001), higher blood glucose levels at admission ( P < .05), predominantly solid US appearances ( P < .001), irregular or indistinct lesion margins ( P < .05), less than 2 mL of pus aspirated ( P < .001), and longer duration of antibiotic treatment ( P < .05).Conclusion: A predominantly solid appearance at US is associated with K pneumoniae monomicrobial liver abscess. K pneumoniae liver abscess is associated with a much smaller quantity of pus at initial aspiration.