BACKGROUND/AIMS: Despite the improvement of personal and social hygiene, pyogenic liver abscess is still a common disease. We compared the incidence, infection route, underlying disease and major complications between two different local hospitals. METHODS: We reviewed the clinical data of 100 patients with pyogenic liver abscess who were treated at Seoul and Guri Hanyang University Hospital from 1999 to 2003. RESULTS: There were 64 males and 36 females in the study group; they were aged from 19 to 94 years with a mean of 56.5 years. Every year 19 to 23 pyogenic liver abscess patients were admitted to both hospitals. The most common organism isolated was Klebsiella pneumoniae in both local hospitals. In the Seoul hospital, diabetes (40.9%) was most common associated condition. In the Guri hospital, biliary tract disease or a history of hepatobiliary surgery (54.2%) was the most common associated condition. Catheter drainage and/or percutaneous needle aspiration were established as the standard treatment modality. CONCLUSIONS: In both regional hospitals, the incidence of pyogenic liver abscess did not decrease and Klebsiella pneumoniae was the most common organism. Diabetes and biliary tract disease, including, previous hepatobiliary surgery, were the most identifiable underlying disease.
Adult ; Aged ; Aged, 80 and over ; English Abstract ; Female ; Humans ; Klebsiella Infections/complications/diagnosis/therapy ; Klebsiella pneumoniae ; *Liver Abscess, Pyogenic/complications/microbiology/therapy ; Male ; Middle Aged

BACKGROUND/AIMS: Pyogenic liver abscess remains a major diagnostic and therapeutic challenge, despite advances in diagnostic technology and new strategies for treatment. This study was conducted to compare the differences in clinical features and outcomes of pyogenic liver abscess according to age. METHODS: In total, 166 patients were enrolled and included 63 (<65 years old, group I), 62 (65-74 years old, group II), 41 (>75 years old, group III) patients in each group. We reviewed the medical records retrospectively including etiology, underlying diseases, characteristics of the liver abscess, laboratory and microbiologic findings, treatment, and outcome of the patients. RESULTS: Group I had higher prevalence rates of male patients and chronic alcoholics, but lower prevalence rates of biliary disease, hypertension, and malignancy. In laboratory findings, group II had higher incidence of thrombocytopenia, elevated blood urea nitrogen and creatinine. There were no differences in symptoms and microbiologic findings in blood and pus among the three groups. Liver abscesses were more common in right liver in Group I. The lengths of stay and the treatment modalities were similar in three groups. CONCLUSIONS: Although there were differences in sex ratio, etiology, underlying disease among the different age groups, they did not cause difference in treatment and clinical outcome of pyogenic liver abscess. Thus, we recommend active treatments in patients of all age.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bacteria/isolation & purification ; Blood Cell Count ; Blood Chemical Analysis ; Female ; Humans ; Liver Abscess, Pyogenic/*diagnosis/microbiology/therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sex Factors ; Urinalysis

BACKGROUND/AIMS: Although pyogenic liver abscesses (PLAs) can be successfully treated, the visual prognosis of patients with endogenous endophthalmitis (EE) associated with a PLA is poor. Early diagnosis and prompt intervention may salvage useful vision. Therefore, we investigated risk factors for EE in patients with PLA, to facilitate early diagnosis. METHODS: Data from 626 patients diagnosed with PLA between January 2004 and July 2013 were analyzed retrospectively. Patients were divided into two groups: those with liver abscess-associated endogenous endophthalmitis (LAEE) and non-LAEE. RESULTS: The prevalence of EE in PLA patients was 1.92%. The mean age for all patients (373 males, 59.6%) was 62.8 years. Upon multivariate logistic regression, a liver abscess or another systemic infection (odds ratio [OR], 5.52; p = 0.005), an abscess in the right superior segment (OR, 5.26; p = 0.035), and Klebsiella pneumoniae infection (OR, 3.68; p = 0.039), were risk factors for LAEE. The final visual outcomes of patients with LAEE included no light perception in seven, hand motion only in three, and decreased visual acuity in two. Vitrectomy and early intravitreal injections of antibiotics improved visual acuity and preserved useful vision. CONCLUSIONS: PLA patients with other systemic infections, abscesses in the right superior segment, and K. pneumoniae infection require close monitoring and early intervention to treat LAEE. Intravitreal antibiotic injections or early vitrectomy may salvage useful vision.
Aged ; Anti-Bacterial Agents/administration & dosage ; Chi-Square Distribution ; Early Diagnosis ; Endophthalmitis/diagnosis/*epidemiology/microbiology/therapy ; Female ; Humans ; Intravitreal Injections ; Liver Abscess, Pyogenic/diagnosis/*epidemiology/microbiology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Visual Acuity ; Vitrectomy