Review for 10.1186/s12876-018-0875-y (2018)

Reviewer ’s report  
Title: A comparison of pyogenic liver abscess in patients with or wi thout diabetes: A 
retrospective study of 246 cases  
 
Version: 0 Date: 18 Jun 2018  
 
Reviewer: Abhishek Agni hotri  
 
Reviewer's report:  
The authors have tried to better characterize liver abscesses seen in the diabetic population. With 
increasing incidence of type 2 Diabetes, we are seeing increasing number of patients with 
Diabetes and PLAs. As the authors mentioned, the largest limitatio n of such a study is its 
retrospective nature and multiple confounding variables. First and foremost, the authors should 
cite a similar study from similar geographical region done by Tian,et al. (Clin Microbiol Infect. 
2012 Sep;18(9):E314 -30.). The methods  are appropriate but there are some important 
considerations. As authors point out, patients with DM, had less incidence of previous surgeries, 
this likely explains why solitary abscesses were more common in Diabetics. It is also important 
to find out what  kind of surgeries or procedures had been done prior, eg. TACE and splenectomy 
have been linked with certain PLAs. It is also worthwhile to study glycemic control of diabetic 
patients, what was the HbA1c of diabetes patients. It is not surprising that Diab etics were older 
and had higher incidence of hypertension given the fact that its incidence is lower in younger age 
group. It will also be interesting to see how many patients required ICU stay or presented with 
severe sepsis, as that would have a bearing on choosing combination antibiotic herapy for broad 
coverage. Overall, I think this is an area of further investigation. With better identification of 
confounding variables, the quality of this study will be improved.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
  
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requ ire further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
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