BACKGROUND/AIMS: With the advance of antibiotics and the development of newer imaging techniques, marked changes in etiology, diagnosis, treatment and prognosis of liver abscess have been reported. METHODS: We reviewed the clinical data related to 94 patients with pyogenic liver abscess. RESULTS: Of the 94 patients in the study group, the male to female ratio was 1.4:1 and the peak incidence of liver abcess was in the 7th decade. About three quaters (74.5%) of the abcesses were of unknown origin. The predominant location was in the right lobe (70.3%). Single lesion was found in 80 patients and multiple lesions in 14 patients. Pathogens were identified in 67 patients, of which Klebsiella pneumoniae (65.7%) and E. coli (16.4%) were the most common. The modalities of treatment were percutaneous drainage with antibiotics (73.4%), percutaneous aspiration with antibiotics (16.0%), or antibiotics alone (8.5%). The case fatality rate, mainly from associated underlying diseases, was 9 cases (9.6%). Associated diseases were diabetes mellitus (14.9%) and malignancy (10.6%). CONCLUSIONS: Our study revealed that the most common organism was Klebsiella pneumoniae and percutaneous needle aspiration and/or catheter drainage were safe and effective treatment modalities for pyogenic liver abscess. Prognosis was determined by the underlying condition.
Adolescent ; Adult ; Child ; English Abstract ; Female ; Humans ; *Liver Abscess, Pyogenic/microbiology/pathology/therapy ; Male ; Middle Aged

BACKGROUND/AIMS: Incidence of pyogenic liver abscess (PLA) has been increasing worldwide, especially in the elderly population. Therefore, the aim of this study is to elucidate the clinical features and outcomes of PLA in elderly patients. METHODS: A total of 602 patients diagnosed with PLA from January 2003 to January 2013 were analyzed retrospectively. The patients were divided according to two age groups; > or =65 years (n=296) and <65 years (n=306). RESULTS: The mean age was 73.59+/-5.98 (range, 65-93) years in the elderly group. Significantly higher incidence of females (52.4% vs. 29.1%, p<0.001), hepatobiliary disease (41.2% vs. 24.8%, p<0.001), hepatobiliary procedure (29.4% vs. 13.7%, p<0.001), underlying malignancy (18.2% vs. 4.6%, p<0.001), culture positivity of resistant organism (20.6% vs. 14.4%, p=0.047), occurrence of complication (19.6% vs. 12.8%, p=0.026), and higher white blood cell (13.44+/-6.56 vs. 12.26+/-5.89, p=0.021), but lower rates of right lobe abscess (67.2% vs. 80.4%, p<0.001), fever (68.6% vs. 79.3%, p=0.003), and lower CRP (16.79+/-9.67 vs. 18.80+/-9.86, p=0.012) was observed in elderly PLA patients, compared to younger patients. Regarding complications, elderly patients had higher incidence of septic shock (8.1% vs. 2.3%, p=0.001) and cardiovascular disease (2% vs. 0%, p=0.014). CONCLUSIONS: More atypical presentations and complications tend to occur in elderly PLA patients compared with younger patients. Clinicians should be aware of these age-related differences in PLA and devise management strategies accordingly.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Cardiovascular Diseases/epidemiology/etiology ; Child ; Drug Resistance, Bacterial ; Escherichia coli/isolation & purification ; Female ; Humans ; Incidence ; Klebsiella pneumoniae/isolation & purification ; Leukocyte Count ; Liver Abscess, Pyogenic/*drug therapy/epidemiology/microbiology/*pathology ; Male ; Middle Aged ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Factors ; Shock, Septic/epidemiology/etiology ; Young Adult