Background
Materials and methods
Results
Clinical features
Clinical outcome | Total (n, %; mean ± SD) | P value | |||||
---|---|---|---|---|---|---|---|
Alive (n, %; mean ± SD) | Death (n, %; mean ± SD) | ||||||
Gender | 0.525 | ||||||
Male | 8 | (89%) | 4 | (67%) | 12 | (80%) | |
Female | 1 | (11%) | 2 | (33%) | 3 | (20%) | |
Age# | 63.8 | ±16.4 | 62.3 | ±19.3 | 63.2 | ±16.9 | 1.000 |
Hospital stay (days) | 42.6 | ±19.2 | 19.0 | ±14.1 | 33.1 | ±20.5 | 0.018* |
Complicated condition | 0.028* | ||||||
Intubation with intensive care unit (ICU) stay ≤3 days | 6 | (67%) | 0 | (0%) | 6 | (40%) | |
Intubation with ICU stay > 3 days | 3 | (33%) | 6 | (100%) | 9 | (60%) | |
Lactatemia (Lactate > 12 mg/dl) | 7 | (88%) | 4 | (80%) | 11 | (85%) | 1.000 |
Hypoalbuminemia (Albumin < 2.5 g/dl) | 2 | (22%) | 6 | (100%) | 8 | (53%) | 0.007** |
Anemia (Hemoglobin < 10 g/dl) | 4 | (44%) | 3 | (50%) | 7 | (47%) | 1.000 |
Leukocytosis (White blood cells > 12,000/mm3) | 6 | (67%) | 4 | (67%) | 10 | (67%) | 1.000 |
Left shift phenomenon (Neutrophils > 80%) | 6 | (75%) | 4 | (67%) | 10 | (71%) | 1.000 |
Bandemia | 2 | (22%) | 2 | (33%) | 4 | (27%) | 1.000 |
Thrombocytopenia (Thrombocytes < 140,000/mm3) | 2 | (22%) | 2 | (33%) | 4 | (27%) | 1.000 |
Hyponatremia (Sodium < 135 mEq/l) | 7 | (78%) | 5 | (83%) | 12 | (80%) | 1.000 |
Hyperkalemia (Potassium > 5.3 mEq/l) | 0 | (0%) | 1 | (17%) | 1 | (7%) | 0.400 |
Hypokalemia (Potassium < 3.5 mEq/l) | 0 | (0%) | 1 | (17%) | 1 | (7%) | 0.400 |
Impaired renal function | |||||||
Blood urea nitrogen (BUN > 25 mg/dl) | 4 | (44%) | 2 | (33%) | 6 | (40%) | 1.000 |
Creatinine (Cr > 1.4 mg/dl) | 4 | (44%) | 3 | (50%) | 7 | (47%) | 1.000 |
BUN/Cr (> 20) | 3 | (33%) | 3 | (50%) | 6 | (40%) | 0.622 |
Impaired liver function (GPT > 50 U/l or GOT > 40 U/l) | 4 | (44%) | 1 | (17%) | 5 | (33%) | 0.580 |
Hyperglycemia (Blood glucose > 200 mg/dl) | 3 | (33%) | 4 | (67%) | 7 | (47%) | 0.315 |
Systolic blood pressure (mmHg)# | 113.7 | ±14.8 | 118.2 | ±20.9 | 115.5 | ±16.9 | 0.768 |
Diastolic blood pressure (mmHg)# | 68.4 | ±10.7 | 73.2 | ±14.0 | 70.3 | ±11.9 | 0.479 |
Heart rate (beats/min)# | 105.8 | ±19.7 | 103.8 | ±17.4 | 105.0 | ±18.2 | 0.679 |
Body temperature (°C)# | 37.0 | ±1.5 | 37.2 | ±0.7 | 37.1 | ±1.2 | 0.407 |
Respiratory rate (breaths/min)# | 18.6 | ±1.3 | 19.7 | ±2.0 | 19.0 | ±1.6 | 0.346 |
Systemic inflammatory response syndrome | 7 | (78%) | 5 | (83%) | 12 | (80%) | 1.000 |
Infectious source c | 0.870 | ||||||
Primary mycotic abdominal aortic aneurysm | 4 | (44%) | 2 | (33%) | 6 | (40%) | |
Stent-graft/endograft infection | 3 | (33%) | 2 | (33%) | 5 | (33%) | |
Infective endocarditis | 2 | (22%) | 2 | (33%) | 4 | (27%) | |
Clinical treatment | 0.235 | ||||||
Antibiotics only | 1 | (11%) | 3 | (50%) | 4 | (27%) | |
Drainage/Surgery | 8 | (89%) | 3 | (50%) | 11 | (73%) | |
Blood culture (n = 9 vs. 5) | 0.580 | ||||||
Monomicrobial (Gram-positive and Gram-negative) | 7 | (78%) | 3 | (60%) | 10 | (71%) | |
Polymicrobial | 2 | (22%) | 2 | (40%) | 4 | (29%) | |
Pus/Tissue culture (n = 4 vs. 3) | 0.429 | ||||||
Monomicrobial (Gram-positive only) | 2 | (50%) | 0 | (0%) | 2 | (29%) | |
Polymicrobial | 2 | (50%) | 3 | (100%) | 5 | (71%) | |
Treatment at other rural hospitals | 2 | (22%) | 2 | (33%) | 4 | (27%) | 1.000 |
Maximum diameter of iliopsoas abscess (IPA)# | 3.7 | ±1.4 | 4.5 | ±2.0 | 4.0 | ±1.6 | 0.480 |
Maximum diameter of IPA > 3 cm | 5 | (56%) | 4 | (67%) | 9 | (60%) | 1.000 |
Gas-forming | 2 | (22%) | 3 | (50%) | 5 | (33%) | 0.329 |
Involvement c | 0.683 | ||||||
Right | 3 | (33%) | 1 | (17%) | 4 | (27%) | |
Left | 2 | (22%) | 1 | (17%) | 3 | (20%) | |
Bilateral | 4 | (44%) | 4 | (67%) | 8 | (53%) | |
Multiple lobulated | 9 | (100%) | 6 | (100%) | 15 | (100%) | – |
Discitis/Paraspinal/Epidural abscess | 0 | (0%) | 3 | (50%) | 3 | (20%) | 0.044* |
Receiving transesophageal echocardiography (TEE) | 6 | (67%) | 3 | (50%) | 9 | (60%) | 0.622 |
Infective endocarditis found on TEE | 2 | (22%) | 2 | (33%) | 4 | (27%) | 1.000 |
Recurrence of IPA | 3 | (33%) | 0 | (0%) | 3 | (20%) | 0.229 |
Tool for follow up | 0.329 | ||||||
Computed tomographic scan | 7 | (78%) | 3 | (50%) | 10 | (67%) | |
No mentioned or Unknown | 2 | (22%) | 3 | (50%) | 5 | (33%) | |
Hypertension | 5 | (56%) | 3 | (50%) | 8 | (53%) | 1.000 |
Diabetes mellitus | 3 | (33%) | 4 | (67%) | 7 | (47%) | 0.315 |
Cerebrovascular accident | 2 | (22%) | 2 | (33%) | 4 | (27%) | 1.000 |
Bed-ridden status | 1 | (11%) | 3 | (50%) | 4 | (27%) | 0.235 |
Malignancy | 2 | (22%) | 1 | (17%) | 3 | (20%) | 1.000 |
Chronic kidney disease | 3 | (33%) | 0 | (0%) | 3 | (20%) | 0.229 |
Alcoholism | 2 | (22%) | 1 | (17%) | 3 | (20%) | 1.000 |
Hemodialysis | 1 | (11%) | 0 | (0%) | 1 | (7%) | 1.000 |
Intravenous drug abuse | 1 | (11%) | 1 | (17%) | 2 | (13%) | 1.000 |
Laboratory investigations
Clinical outcome | Total (n = 15; mean ± SD) | P value | |||||
---|---|---|---|---|---|---|---|
Alive (n = 9; mean ± SD) | Death (n = 6; mean ± SD) | ||||||
White blood cells (× 103/mm3)# | 14.1 | ±5.5 | 16.8 | ±9.1 | 15.2 | ±7.0 | 0.906 |
Neutrophils (%)# | 84.3 | ±10.5 | 81.9 | ±13.5 | 83.3 | ±11.4 | 0.860 |
Band (%)# | 2.6 | ±5.1 | 0.8 | ±1.6 | 1.9 | ±4.1 | 0.880 |
Hemoglobin (g/dl)# | 10.9 | ±2.2 | 11.1 | ±3.1 | 11.0 | ±2.5 | 0.860 |
Thrombocytes (×103/mm3)# | 241.4 | ±191.8 | 188.0 | ±114.5 | 220.1 | ±162.6 | 0.480 |
Albumin (g/dl)# | 2.9 | ±0.5 | 2.2 | ±0.3 | 2.6 | ±0.6 | 0.009** |
Alkaline phosphatase (U/l)# | 189.0 | ±83.3 | 281.7 | ±195.2 | 226.1 | ±140.7 | 0.316 |
Glutamic oxaloacetic transaminase (U/l)# | 38.7 | ±27.8 | 32.8 | ±14.5 | 36.6 | ±23.4 | 0.640 |
Glutamic pyruvic transaminase (U/l)# | 45.2 | ±33.4 | 38.5 | ±18.7 | 42.5 | ±27.8 | 0.953 |
Lactic dehydrogenase (U/l)# | 260.4 | ±87.0 | 246.2 | ±117.3 | 255.4 | ±94.6 | 0.739 |
C-reactive protein (mg/dl)# | 19.2 | ±9.7 | 15.5 | ±5.4 | 17.7 | ±8.2 | 0.409 |
Glucose (mg/dl)# | 192.0 | ±85.6 | 223.0 | ±126.5 | 204.4 | ±100.8 | 1.000 |
Lactate (mg/dl)# | 26.2 | ±25.4 | 38.4 | ±45.4 | 30.9 | ±33.2 | 0.558 |
Sodium (mEq/l)# | 132.6 | ±2.6 | 128.8 | ±3.6 | 131.1 | ±3.5 | 0.032* |
Potassium (mEq/l)# | 4.0 | ±0.4 | 4.7 | ±0.9 | 4.3 | ±0.7 | 0.058 |
Blood urea nitrogen (mg/dl)# | 44.0 | ±59.2 | 23.8 | ±9.2 | 35.9 | ±46.2 | 0.953 |
Creatinine (mg/dl)# | 2.1 | ±2.3 | 1.4 | ±0.4 | 1.8 | ±1.8 | 0.723 |
pH# | 7.4 | ±0.1 | 7.5 | ±0.1 | 7.4 | ±0.1 | 0.637 |
PaCO2 (mmHg)# | 35.1 | ±9.7 | 32.8 | ±8.5 | 34.2 | ±9.0 | 0.637 |
HCO3− (mEq/l)# | 22.4 | ±6.1 | 22.8 | ±7.0 | 22.6 | ±6.2 | 0.814 |
Etiological pathogens
Microorganisms | Culture of pus/tissue (n, %) | Culture of blood (n, %) |
---|---|---|
Gram-positive | 5 (33.3%) | 9 (60%) |
Staphylococcus aureus | 3 (20%) | 6 (40%) |
Streptococcus mitis group | 1 (6.7%) | 1 (6.7%) |
Cutibacterium acnes (Propionibacterium acnes)^ | 1 (6.7%) | 0 (0%) |
Bacillus cereus | 0 (0%) | 1 (6.7%) |
Listeria monocytogenes% | 0 (0%) | 1 (6.7%) |
Gram-negative | 5 (33.3%) | 8 (53.3%) |
Salmonella$ | 1 (6.7%) | 4 (26.7%) |
Acinetobacter baumannii | 1 (6.7%) | 0 (0%) |
Escherichia coli | 1 (6.7%) | 1 (6.7%) |
Klebsiella pneumoniae | 1 (6.7%) | 1 (6.7%) |
Prevotella sp.^ * | 1 (6.7%) | 0 (0%) |
Pseudomonas aeruginosa | 0 (0%) | 1 (6.7%) |
Veillonella sp.^ | 0 (0%) | 1 (6.7%) |
Fungus | 2 (13.3%) | 1 (6.7%) |
Candida# | 2 (13.3%) | 1 (6.7%) |