Misdiagnosis of pyogenic hepatic abscess in patients with diabetes mellitus

Objective To analyze the causes of misdiagnosis of pyogenic hepatic abscess in patients with diabetes mellitus (PHADM) so as to improve diagnostic accuracy. Methods A retrospective study was conducted on 86 patients with pyogenic liver abscess and diabetes mellitus (PHADM) who were admi-tted to our hospital from Jan. 2005 to May. 2015. The chief complaints on presentation, complications, laboratory findings, diagnosis, misdiagnosis results, methods used to diagnose liver abscess and approaches to definite diagnosis were analyzed. Results (1) Of the 86 PHADM patients, only 42 patients (48.8%) complained of right upper quadrant discomfort or pain. For the remaining 44 patients (51.2%) the chief complaints were not related to the right upper quadrant. (2) The PHADM patients often suffered from multiple complications. (3) The laboratory results were non-specific for diagnosis. (4) The correct diagnosis made at the first visit was only 57.0%. The patients with PHADM were often misdiagnosed to suffer from upper respiratory infection and gastritis. (5) In 64 of the 86 PHADM patients (74.4%), liver abscesses were identified by ultrasonography. Conclusions The main reason why PHADM was frequently misdiagnosed was because of non-specific symptoms at primary presentation. Hepatic ultrasound should be carried out in patients with diabetes mellitus who suffer from fever. Key words: Diabetes mellitus; Pyogenic hepatic abscess; Misdiagnosis