Objective To investigate the clinical features and risk factors of pyogenic liver abscess complicated with extrahepatic infection.

Methods The clinical data of 164 pyogenic with pyogenic liver abscess were retrospectively analyzed, and divided into the extrahepatic infection group(62 cases) and nonextrahepatic infection group(102 cases). The etiology, clinical features, laboratory indicators and extrahepatic infection in two groups were analyzed. The risk factors of bacterial liver abscess complicated with extra-hepatic infection were analyzed by logistic regression analysis.

Results There was no statistical significance in the gender, underlying diseases(diabetes mellitus, hypertension, biliary tract disease, heart disease, cerebral infarction, cirrhosis, malignant tumor, chronic viral hepatitis and fatty liver), surgical history and drinking history between two groups(P > 0.05). The age in the extrahepatic infection group was higher than that in nonextrahepatic infection group, the diameter of abscess in the extrahepatic infection group was smaller tann that in nonextrahepatic infection group, and the incidence rates of cough, diarrhea, pleural effusion and pleural thickening in the extrahepatic infection group were significantly higher than those in nonextrahepatic infection group (P < 0.05 to P < 0.01). The levels of white blood cells, neutrophils, percentage of neutrophils, total bilirubin and procalcitonin in the extrahepatic infection group were higher than those in nonextrahepatic infection group(P < 0.05 to P < 0.01), and the levels of platelet and albumin in the extrahepatic infection group were lower than those in nonextrahepatic infection group(P < 0.01 and P < 0.05). The results of logistic regression analysis showed that the abscess diameter was the independent factor of extrahepatic infection in patients with pyogenic liver abscess (P < 0.01).

Conclusions Pyogenic liver abscess complicated with extrahepatic infection is more likely to occur in elderly patients, and has complications such as septicemia and pleural effusion. Patients with smalldiameter pyogenic liver abscess should be vigilant about the occurrence of extrahepatic infection.