Abstract
ObjectivesThis study aimed to analyse the epidemiological, aetiological and clinical characteristics of pyogenic liver abscess (PLA) occurring in Oman. The intention was to obtain the information needed for the adequate liver abscess (LA) empirical treatment. LA can develop as a complication of hepatobiliary disease or other intraabdominal infections, but more recently, it is associated with primary and secondary liver malignancies and their treatment.MethodsThis retrospective study took place in the Royal Hospital, Muscat, Oman. Consecutive patients treated for LA from January 2013 to December 2017 were enrolled. Their demographic and clinical data were used to study the characteristics of PLA occurring in Oman.ResultsA total of 53 patients with PLA were enrolled in the study. They were predominantly male and younger than 60 years. Klebsiella pneumoniae was found to be the most common bacteria causing LA. Clinical presentation was non-specific, and abdominal pain and high fever were the most common symptoms.ConclusionThe majority of PLAs are caused by K. pneumoniae, so the empirical treatment should begin with antibiotic directed against it. Further studies are needed to establish the local role of anaerobic bacteria in PLA and monitor the presence of hypervirulent K. pneumoniae in Oman.
Highlights
Liver abscess (LA) is defined as an encapsulated collection of pus within the liver parenchyma
The majority of LAs are caused by bacteria generating a pyogenic liver abscess (PLA) while parasites and fungi are less common LA causes.[1]
53 patients had PLA while the remaining 23 had amoebic LA so they were excluded from the analysis
Summary
Liver abscess (LA) is defined as an encapsulated collection of pus within the liver parenchyma. Previous studies showed a significant difference in PLA etiology. In Europe and North America Escherichia coli (E. coli), Staphylococcus spp, Streptococcus spp. and Enterococcus spp. are the most common causes of PLA while in Asia the predominant bacteria causing PLA is Klebsiella pneumoniae (K. pneumoniae).[7] Several studies showed that K. pneumoniae is the main cause of cryptogenic PLA regardless geographical distribution.[6,8] The characteristics of PLA in Gulf countries are not well known. As per the authors’ knowledge, one study from Qatar and few case reports from Oman and KSA describing PLA were published so far.[9,10,11]
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