A Retrospective Study of Demographics and Treatment Outcomes of Culture-Negative Versus Culture-Positive Pyogenic Liver Abscess: 12 Years-Experience at A Tertiary Hospital
Abstract
Objective: To evaluate the demographics and treatment outcome of culture-negative pyogenic liver abscess (CNPLA), compared with culture-positive pyogenic liver abscess (CPPLA).
Material and Methods: A retrospective study of patients admitted with pyogenic liver abscess (PLA) at a tertiary hospital, from January 2011 to May 2023, was performed.
Results: A total of, 112 patients had PLA: 33 patients (29.5%) were CNPLA, and 79 patients (70.5%) were CPPLA. The median age was 60.5 years. Patients with CNPLA were significantly younger than those with CPPLA (58 vs. 62 years, p-value=0.021). The most common bacteria in CPPLA was Klebsiella pneumoniae. Jaundice was more common in CPPLA. CNPLA had significantly lower bilirubin (0.6 vs. 1.2 mg/dl, p-value=0.020), aspartate transferase (AST) (30 vs. 55 U/L, p-value<0.001), alanine aminotransferase (ALT) (39 vs. 57 U/L, p-value=0.011), alkaline phosphatase (ALP) (192 vs. 231 U/L, p-value=0.046) and higher albumin (3.3 vs. 2.9 g/dl, p-value=0.025) levels than CPPLA. Mortality of CNPLA and CPPLA were not different (9.1% vs. 8.9%, p-value=1.000). There was no difference in length of stay between the two groups (15 vs. 12 days, p-value=0.388).
Conclusion: Patients with CNPLA were younger than CPPLA and compared with CPPLA, CNPLA had lower bilirubin, AST, ALT, ALP, and higher albumin levels. Antibiotics combined with percutaneous aspiration or drainage are the primary treatments for PLA. Mortality and length of stay of CNPLA and CPPLA were not different. CNPLA should be treated the same as CPPLA.
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