Time and departments of consultation affecting pyogenic liver abscess diagnosis.
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| Title: | Time and departments of consultation affecting pyogenic liver abscess diagnosis. |
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| Alternate Title: | Tiempo y departamentos de consulta que afectan el diagnóstico de absceso hepático piógeno. |
| Authors: | Hu, Yangbo1 (AUTHOR), Mou, Yijiao1 (AUTHOR), Lei, Maoxin1 (AUTHOR), Wang, Wenjing1 (AUTHOR) njmuwwj@yeah.net |
| Source: | Medicina (Buenos Aires). nov/dic2025, Vol. 85 Issue 6, p1312-1325. 14p. |
| Subjects: | PYOGENIC liver abscess, EARLY diagnosis, DELAYED diagnosis, HOSPITAL wards, OUTPATIENTS, LIVER abscesses |
| Abstract (English): | Introduction: This article surveys the time from symptom onset to consultation and diagnosis of pyogen ic (bacterial) liver abscess patients, depicts first special ized outpatient visit and hospitalization departments, and analyzes influencing factors to aid early diagnosis. Materials and methods: Patients diagnosed with pyogenic liver abscess from 2013 to 2023 were studied through retrospective medical record review. Results: 191 patients (63.9% male, age 64.8 ± 13.8 years) were included. Patients with pyogenic liver ab scess may present with respiratory (33%), neurological (32%), urinary (17%), and cardiovascular (10%) mani festations. Median time from symptom onset to initial medical consultation, initial consultation to diagnosis, and symptom onset to diagnosis were 2 days (IQR 1, 4), 4 days (IQR 2, 7), and 7 days (IQR 4, 11), respectively; 16% of patients initially sought specialized outpatient visit in endocrinology, neurology, cardiology, nephrology, and pulmonology departments. Of these, 83% were hospital ized with varied initial diagnoses including diabetes, cerebral infarction, acute coronary syndrome, pneumonia, and acute pyelonephritis. Factors influencing the time to consultation and diagnosis included high fever (Tmax>39°C), emaciation, nausea, differences in initial hospitalization and diagnostic departments, low albumin (<30g/L), and thrombocytopenia. Discussion: The non-specific and sometimes mislead ing symptoms of pyogenic liver abscess leads patients to seek care in inappropriate specialized outpatient depart ments, resulting in erroneous preliminary diagnoses by physicians and consequently delaying the correct diag nosis. Clinicians should conduct thorough and careful inquiries and physical examinations, choose appropriate and effective diagnostic modalities, and make accurate diagnoses as early as possible. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Introducción: Este artículo analiza el tiempo de con sulta y diagnóstico en pacientes con absceso hepático piogénico (bacteriano), describe la primera consulta y departamento de hospitalización, y analiza factores para el diagnóstico precoz. Materiales y métodos: Se efectuó una revisión retros pectiva de historias clínicas de pacientes diagnosticados entre 2013 y 2023. Resultados: Se incluyeron 191 pacientes (63,9% varo nes, edad 64,8 ± 13,8 años). Presentaron manifestaciones respiratorias (33%), neurológicas (32%), urinarias (17%) y cardiovasculares (10%). La mediana del tiempo desde síntomas a primera consulta, a diagnóstico y desde síntomas a diagnóstico fue de 2 (RIC 1, 4), 4 (RIC 2, 7) y 7 días (RIC 4, 11) respectivamente. El 16% consultó inicialmente en especialidades como endocrinología. El 83% fue hospitalizado con diagnósticos iniciales erró neos. Factores influyentes fueron fiebre alta, emaciación, náuseas, diferencias en hospitalización y diagnóstico inicial, baja albúmina y trombocitopenia. Discusión: Los síntomas inespecíficos llevan a consul tas inadecuadas y diagnósticos erróneos, retrasando el correcto. Los clínicos deben examinar exhaustivamente, elegir buenas modalidades de diagnóstico, y efectuar el diagnóstico precozmente. [ABSTRACT FROM AUTHOR] |
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| Database: | MedicLatina |
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| Abstract: | Introduction: This article surveys the time from symptom onset to consultation and diagnosis of pyogen ic (bacterial) liver abscess patients, depicts first special ized outpatient visit and hospitalization departments, and analyzes influencing factors to aid early diagnosis. Materials and methods: Patients diagnosed with pyogenic liver abscess from 2013 to 2023 were studied through retrospective medical record review. Results: 191 patients (63.9% male, age 64.8 ± 13.8 years) were included. Patients with pyogenic liver ab scess may present with respiratory (33%), neurological (32%), urinary (17%), and cardiovascular (10%) mani festations. Median time from symptom onset to initial medical consultation, initial consultation to diagnosis, and symptom onset to diagnosis were 2 days (IQR 1, 4), 4 days (IQR 2, 7), and 7 days (IQR 4, 11), respectively; 16% of patients initially sought specialized outpatient visit in endocrinology, neurology, cardiology, nephrology, and pulmonology departments. Of these, 83% were hospital ized with varied initial diagnoses including diabetes, cerebral infarction, acute coronary syndrome, pneumonia, and acute pyelonephritis. Factors influencing the time to consultation and diagnosis included high fever (Tmax>39°C), emaciation, nausea, differences in initial hospitalization and diagnostic departments, low albumin (<30g/L), and thrombocytopenia. Discussion: The non-specific and sometimes mislead ing symptoms of pyogenic liver abscess leads patients to seek care in inappropriate specialized outpatient depart ments, resulting in erroneous preliminary diagnoses by physicians and consequently delaying the correct diag nosis. Clinicians should conduct thorough and careful inquiries and physical examinations, choose appropriate and effective diagnostic modalities, and make accurate diagnoses as early as possible. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00257680 |
