DOI: 10.1111/myc.13636 ISSN: 0933-7407

Analysis of 15 cases from a monocentric cohort of 307 liver abscesses

Etienne Canouï, Geoffrey Rossi, Yann Nguyen, Emmanuel Lafont, Benjamin Rossi, Olivier Roux, Safi Dokmak, Frédéric Bert, Véronique Leflon‐Guibout, Bruno Fantin, Agnès Lefort
  • Infectious Diseases
  • Dermatology
  • General Medicine

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.

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