Clinical analysis of 12 cases of diabetes complicated with Klebsiella pneumoniae liver abscess
Objective To analyze the clinical features,etiological examination,laboratory examination,imaging examination,and treatment of patients with diabetes combined with Klebsiella pneumoniae liver abscess(KPLA),and to provide a reference for clinical work.Methods The clinical data of patients with diabetes combined with KPLA in the First People's Hospital of Neijiang City from 2021 to 2022 were retrospectively analyzed.Results Among the 12 patients with diabetes combined with KPLA,there were 8 males and 4 females,aged 47-74 years old.Five cases were combined with biliary tract diseases,3 cases were combined with syphilis,and 2 cases were combined with hepatitis B.The main clinical manifestations included fever(12 cases),anorexia(10 cases),stomachache(6 cases),dizziness(2 cases),weakness(3 cases),cough and sputum(2 cases),disturbance of consciousness(2 cases),and visual impairment(1 case).Laboratory test results showed an increase in the percentage of neutrophils,glycosylated hemoglobin,transaminase,C-reactive protein,and procalcitonin,as well as a decrease in platelets and albumin.Abdominal CT findings were predominantly unilateral lesions,mostly found in the right liver,mainly manifested as mass,flaky,and nodular shadows.Two patients presented with invasive syndromes,2 cases had lung abscesses,and 1 case had concomitant endophthalmitis and meningitis.The etiological examination of 12 patients with Klebsiella pneumoniae showed that they were all sensitive bacteria.After actively controlling blood glucose,effectively using antibiotics,and performing liver puncture and drainage,11 cases improved,while 1 case was left with permanent blindness.Conclusions The clinical features of diabetes combined with KPLA are atypical and easy to misdiagnose,thus early imaging and etiological examination should be performed.Aggressive glucose control,and selection of sensitive antimicrobial drugs based on drug sensitivity tests combined with liver abscess puncture and drainage can help to improve the prognosis.
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