Critical Care Management Considerations in

Importance: Objectives: This article aims to describe the clinical characteristics of hospitalized and critically ill patients with ILAS and providing management considerations for critical care clinicians. Main Outcomes and Measures: Adult patients admitted to Scripps Health from Janurary 1, 2018 to April 1, 2024 were reviewed. Inclusion criteria required radiographic evidence of a liver abscess and cultures (blood or abscess) positive for Results: Six patients had ILAS. Mean age was 54.8 years, no immunosuppression (defined as underlying malignancy, drug-induced, or chronic infection), 83% had diabetes, 50% were male, and 50% were of Asian ethnicity. Liver abscesses were multilocular (50%), and all had percutaneous catheter drainage. Fifty percent of patients developed distant metastatic infections: emphysematous cystitis, pulmonary septic emboli, complicated parapneumonic pleural effusions, meningitis, ventriculitis, cerebral septic emboli, and endophthalmitis. These patients were younger, male, and had a higher rate of intensive care unit (ICU) admission and mechanical ventilation. Two patients required ICU admission with septic shock, diabetic ketoacidosis, respiratory failure, severe thrombocytopenia, and altered mental status. Conclusions and Relevance: ILAS is an emerging disease that can cause severe critical illness with multiorgan involvement. Early identification of the disease and metastatic infection is essential to provide appropriate treatment. Additionally, ILAS patients require screening for endophthalmitis.