Clinical characteristics and risk factors of pyogenic liver abscess complicated by sepsis in children
WANG Xue-Li, LIU Quan-Bo
Department of Infection, Children's Hospital Affiliated to Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China
Abstract：Objective To study the clinical characteristics and risk factors of pyogenic liver abscess complicated by sepsis in children. Methods A retrospective analysis was conducted on the clinical data of 120 children with pyogenic liver abscess admitted from May 2004 to January 2024. According to the presence of sepsis, the children were divided into a sepsis group (82 cases) and a non-sepsis group (38 cases). The clinical characteristics of the two groups were compared, and risk factors associated with the occurrence of sepsis were identified. Results Among the 120 children with pyogenic liver abscess, 68.3% (82/120) had sepsis. Multivariate logistic regression analysis showed that fever, elevated white blood cell count, and decreased albumin level were closely associated with the occurrence of sepsis (P<0.05). Receiver operating characteristic curve analysis indicated that white blood cell count and albumin levels had significant predictive value for sepsis (P<0.05), and the combination of white blood cell count and albumin level showed higher predictive value for sepsis than the albumin level alone (P<0.05). Conclusions The clinical manifestations of children with pyogenic liver abscess complicated by sepsis are non-specific. Fever, elevated white blood cell count, and decreased albumin level are risk factors for sepsis in children with pyogenic liver abscess. Clinically, for children with unexplained fever and imaging suggestive of liver abscess, pyogenic liver abscess should be considered. If laboratory tests show elevated white blood cell count and decreased albumin level simultaneously, there should be a high level of suspicion for the development of sepsis.
WANG Xue-Li,LIU Quan-Bo. Clinical characteristics and risk factors of pyogenic liver abscess complicated by sepsis in children[J]. CJCP, 2025, 27(3): 328-333.
5 Xanthokos SA, Balistreri WF. Liver Abscess[M]//Kliegman RM, Stanton BF St, Geme RW Ⅲ. Nelson Textbook of Pediatrics. 18th ed. Philadelphia: Elsevier Saunders, 2007: 1670-1692.
Kaplan GG, Gregson DB, Laupland KB. Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess[J]. Clin Gastroenterol Hepatol, 2004, 2(11): 1032-1038. PMID: 15551257. DOI: 10.1016/s1542-3565(04)00459-8.
Ramachandran S, Mishra K, Choudhury SR, et al. Clinico-socio-demographic profile and predictors of poor outcome in children with liver abscess: a hospital-based study in northern India[J]. Trop Doct, 2012, 42(4): 226-228. PMID: 23405006. DOI: 10.1258/td.2012.120266.
Park KS, Lee SH, Yun SJ, et al. Neutrophil-to-lymphocyte ratio as a feasible prognostic marker for pyogenic liver abscess in the emergency department[J]. Eur J Trauma Emerg Surg, 2019, 45(2): 343-351. PMID: 29480320. DOI: 10.1007/s00068-018-0925-8.
Gong Y, Li D, Cheng B, et al. Increased neutrophil percentage-to-albumin ratio is associated with all-cause mortality in patients with severe sepsis or septic shock[J]. Epidemiol Infect, 2020, 148: e87. PMID: 32238212. PMCID: PMC7189348. DOI: 10.1017/S0950268820000771.
