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Infection

, Volume 41, Issue 6, pp 1137–1143 | Cite as

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. LiuEmail author
Clinical and Epidemiological Study

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.

Keywords

Pylephlebitis Klebsiella pneumoniae 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Y. -F. Wang
    • 1
  • C. -C. Chang
    • 1
  • T. -C. Lee
    • 2
  • I. -L. Shih
    • 1
  • W. -C. Lien
    • 3
  • S. -J. Chen
    • 1
  • H. -P. Wang
    • 2
  • K. -L. Liu
    • 1
    Email author
  1. 1.Department of Medical ImagingNational Taiwan University Hospital, National Taiwan University College of MedicineTaipeiTaiwan
  2. 2.Department of Internal MedicineNational Taiwan University Hospital, National Taiwan University College of MedicineTaipeiTaiwan
  3. 3.Department of Emergency MedicineNational Taiwan University Hospital, National Taiwan University College of MedicineTaipeiTaiwan

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