Recent trend of pylephlebitis in Taiwan: Klebsiella pneumoniae liver abscess as an emerging etiology
Journal
Infection
Journal Volume
41
Journal Issue
6
Pages
1137-1143
Date Issued
2013
Author(s)
Abstract
Background and aims: Pylephlebitis (septic thrombophlebitis of the portal venous system) is a rare complication of intra-abdominal infection. We aimed to investigate the recent trend of its etiology, clinical manifestation, and prognosis. Methods: We retrospectively studied the etiology, clinical manifestation, and outcome by reviewing the medical records of all imaging-confirmed pylephlebitis cases diagnosed during the period 2002-2011 in a university hospital in Taiwan. To identify the risk factors for pylephlebitis, we randomly selected 160 patients with intra-abdominal infections but without pylephlebitis as the comparison group. Results: We identified 35 cases of pylephlebitis. Most patients were men [29/35 (83 %)]. The median age of the patients was 57 years (range 35-90 years). Unspecified abdominal pain (18/35) and fever (10/35) were the most common clinical manifestations. Klebsiella pneumoniae liver abscess (7/35) and cholangitis (7/35) were the most common etiologies. Liver abscess was a risk factor for pylephlebitis (13/35 vs. 27/160, P = 0.01). With antibiotic therapy, there was no in-hospital mortality, but pylephlebitis was still associated with an excess hospital stay (22.2 ± 17.6 vs. 9.8 ± 7.1 days, P < 0.001). Conclusions: Our study results suggested a different pattern of pylephlebitis from previous Western literature. K. pneumoniae liver abscess (7/35) is an emerging etiology of pylephlebitis in Taiwan. ? 2013 Springer-Verlag Berlin Heidelberg.
SDGs
Other Subjects
alanine aminotransferase; aspartate aminotransferase; bilirubin; C reactive protein; ceftriaxone; cephalosporin derivative; ciprofloxacin; clindamycin; enoxaparin; flomoxef; metronidazole; piperacillin plus tazobactam; sultamicillin; teicoplanin; urokinase; vancomycin; abdominal infection; abdominal pain; acute cholecystitis; adult; aged; antibiotic therapy; article; beta hemolytic Streptococcus; biliary tract infection; chill; cholangitis; controlled study; diverticulitis; enterocolitis; Escherichia coli; female; fever; hospital admission; human; Klebsiella pneumoniae; Klebsiella pneumoniae infection; laboratory test; length of stay; liver abscess; liver function; major clinical study; malaise; male; mesenteric vein thrombosis; phlebitis; portal vein; portal vein infection; recanalization; retrospective study; risk factor; Streptococcus intermedius; Taiwan; Adult; Aged; Aged, 80 and over; Case-Control Studies; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess; Male; Middle Aged; Portal Vein; Retrospective Studies; Taiwan; Thrombophlebitis
Type
journal article