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首页> 外文期刊>Acta Radiologica >Clinical and radiological features of invasive Klebsiella pneumoniae liver abscess syndrome
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Clinical and radiological features of invasive Klebsiella pneumoniae liver abscess syndrome

机译：侵袭性肺炎克雷伯菌肝脓肿综合征的临床和影像学特征

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Background: Recently, a striking new clinical manifestation of Klebsiella pneumoniae (KP) infection referred to as invasive KP liver abscess syndrome (IKPLAS), defined by liver abscess with contemporaneous metastatic KP infections at other body sites has been documented. Until now, however, there have been relatively few reports regarding its radiologic features. Purpose: To describe the clinical and radiological features of IKPLAS patients, and to compare them with those with KP liver abscess without metastatic infections to ascertain possible predictors of IKPLAS. Material and Methods: From January 2008 to May 2010, 35 patients (26 men and 9 women; mean age, 59.4 years) with both liver abscess and metastatic KP infections were diagnosed with IKPLAS. Their clinical and radiological features were retrospectively evaluated and compared with those of 25 contemporaneous nonmetastatic patients to investigate predictive factors for metastatic infections. Results: The rate of intensive care unit admissions and overall mortality was 34.3% and 17.1% in IKPLAS patients, and was significantly higher than those of the non-metastatic group (8% and 0%, respectively). As for metastatic infections, the lung was the most common site and multiple nodules or masses (n = 9) were the most common manifestations. Univariate analysis revealed that liver abscess ≤5.8 cm, bilobar involvement of abscess and altered mentality were significantly related with IKPLAS. At multivariate analysis, liver abscess ≤5.8 cm was proven to be a significant independent predictor of IKPLAS (OR, 3.6; P = 0.038). In addition, altered mentality was present solely in IKPLAS (25.7% vs. 0%) although its P value (P = 0.052) did not reach a statistical significance at multivariate analysis. Conclusion: IKPLAS has significantly worse prognosis than non-metastatic KP abscess patients. In patients with KP liver abscess, liver abscess ≤5.8 cm can be used as an independent predictor of IKPLAS and altered mentality as a very specific feature in diagnosing IKPLAS.
机译：背景：最近，已有文献报道肺炎克雷伯氏菌（KP）感染的一种新的临床表现，称为侵袭性KP肝脓肿综合征（IKPLAS），其定义为在其他身体部位同时存在转移性KP感染的肝脓肿。然而，到目前为止，关于其放射学特征的报道相对较少。目的：描述IKPLAS患者的临床和影像学特征，并将其与无转移性感染的KP肝脓肿患者进行比较，以确定IKPLAS的可能预测因素。材料与方法：2008年1月至2010年5月，IKPLAS诊断为肝脓肿和转移性KP感染的35例患者（男26例，女9例;平均年龄59.4岁）。对他们的临床和放射学特征进行回顾性评估，并与25例同期非转移患者进行比较，以研究转移性感染的预测因素。结果：IKPLAS患者的重症监护病房入院率和总死亡率分别为34.3％和17.1％，显着高于非转移组（分别为8％和0％）。至于转移性感染，肺是最常见的部位，多发结节或肿块（n = 9）是最常见的表现。单因素分析显示，肝脓肿≤5.8cm，脓肿双叶受累和心态改变与IKPLAS密切相关。在多变量分析中，肝脓肿≤5.8cm被证明是IKPLAS的重要独立预测因子（OR，3.6; P = 0.038）。此外，虽然IKPLAS的P值（P = 0.052）在多变量分析中未达到统计学意义，但仅在IKPLAS中存在改变的心态（25.7％vs. 0％）。结论：IKPLAS的预后明显优于非转移性KP脓肿患者。对于KP肝脓肿，≤5.8cm的肝脓肿可作为IKPLAS的独立预测指标，并且改变心态可作为IKPLAS诊断的非常特殊的特征。

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