Recent trend of pylephlebitis in Taiwan: Klebsiella pneumoniae liver abscess as an emerging etiology

Y. F. Wang, C. C. Chang, T. C. Lee, I. L. Shih, W. C. Lien, S. J. Chen, H. P. Wang, K. L. Liu

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1137-1143
Number of pages7
JournalInfection
Volume41
Issue number6
DOIs
Publication statusPublished - Dec 2013
Externally publishedYes

Keywords

  • Klebsiella pneumoniae
  • Pylephlebitis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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