Specificities of acute cholangitis in patients with cancer: a retrospective comparative study of 130 episodes

Eur J Clin Microbiol Infect Dis. 2022 Jan;41(1):143-146. doi: 10.1007/s10096-021-04289-0. Epub 2021 Aug 20.

Abstract

Pancreatic and biliary duct cancers are increasing causes of acute cholangitis (AC). We retrospectively characterize 81 cancer-associated cholangitis (CAC) compared to 49 non-cancer-associated cholangitis (NCAC). Clinical and biological presentations were similar. However, in CAC, antibiotic resistance and inadequate empirical antibiotic therapy were more frequent; more patients required ≥ 2 biliary drainages; and mortality at day 28 was higher than in NCAC. Death was associated with initial severity and CAC in a multivariate analysis. Cholangitis associated with pancreatic or biliary duct cancers requires specific empirical antimicrobial therapy; early use of biliary drainage may improve outcomes.

Keywords: Antibiotic resistance; Bacterial cholangitis; Biliary drainage; Cancer.

MeSH terms

  • Acute Disease / therapy
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Cholangitis / drug therapy
  • Cholangitis / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents