Analysis of 15 cases from a monocentric cohort of 307 liver abscesses.
Mycoses
; 66(11): 984-991, 2023 Nov.
Article
in En
| MEDLINE
| ID: mdl-37534436
ABSTRACT
BACKGROUND:
Out of the context of haematological patients, Candida sp. is rarely retrieved from pyogenic liver abscesses (PLA).OBJECTIVES:
Our objective was to assess the risk factors for occurrence, and clinical, microbiological characteristics, management and outcome of Candida pyogenic liver abscesses (C-PLA). PATIENTS/METHODS:
We retrospectively analysed C-PLA cases and compared them to pyogenic liver abscesses exclusively due to bacteria (B-PLA) included in our monocentric database on liver abscesses. Unfavourable course was defined as the occurrence of a primary treatment failure (PTF), recurrence after an initial cure, or death within 3 months after diagnosis.RESULTS:
Between 2010 and 2018, 15 C-PLA and 292 B-PLA were included. All C-PLA had a biliary origin and were polymicrobial. All patients with C-PLA had at least one comorbidity at risk for Candida infection and 7 (53.3%) presented with sepsis requiring an admission in intensive care unit. Median duration of antifungal treatment was 42 days [24-55]. In multivariate analysis, compared with B-PLA, a medical history of malignancy (OR 4.16; 95%CI 1.15-18.72) or liver abscess (OR 7.39; 95%CI 2.10-26.62), and sepsis with severity criteria (OR 3.52; 95%CI 1.07-11.90) were independently associated with the occurrence of C-PLA. In multivariate analysis, C-PLA was associated with a higher risk of recurrence (HR 3.08; 95%CI 1.38-11.22).CONCLUSION:
Candida liver abscesses in non-neutropenic is a rare and severe disease. The high rate of recurrence should lead to discuss a more intensive treatment.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Sepsis
/
Liver Abscess, Pyogenic
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Mycoses
Journal subject:
MICROBIOLOGIA
Year:
2023
Type:
Article
Affiliation country:
France