1.A Case of Salmonella Liver Abscess.
Jeong Woo CHOI ; Sung Jun CHOI ; Hyeock Choon KWON ; Jae Youn CHEONG ; Ki Myung LEE ; Byeong Moo YOO ; Ki Baik HAHM ; Jin Hong KIM ; Sung Won CHO
The Korean Journal of Gastroenterology 2006;47(4):316-319
Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
Humans
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Liver/radiography/ultrasonography
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Liver Abscess, Pyogenic/*diagnosis/microbiology
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Male
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Middle Aged
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Salmonella Infections/*diagnosis
2.A Clinical Study of Pyogenic Liver Abscess at Two Different Local Hospitals.
Dae Won JUN ; Ji Yong MOON ; Sang Hyeon BAEG ; Ho Soon CHOI ; Joo Hyun SOHN ; Oh Young LEE ; Byung Chul YOON ; Min Ho LEE ; Dong Hoo LEE ; Choon Suhk KEE
The Korean Journal of Hepatology 2005;11(3):250-260
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
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Aged
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Aged, 80 and over
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English Abstract
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Female
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Humans
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Klebsiella Infections/complications/diagnosis/therapy
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Klebsiella pneumoniae
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*Liver Abscess, Pyogenic/complications/microbiology/therapy
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Male
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Middle Aged
3.Comparison of Liver Abscess between Diabetic Patients and Non-Diabetic Patients.
Chang Jae LEE ; Dong Sik JUNG ; Suk Hee JUNG ; Jung Hoan BAIK ; Jung Hyun LEE ; Young Rak CHO ; Byoung Soung GO ; Sung Wook LEE ; Sang Young HAN ; Dong Hyun LEE
The Korean Journal of Hepatology 2005;11(4):339-349
BACKGROUND/AIMS: Klebsiella pneumoniae is emerging as the leading cause for liver abscess although the most common pathogen was Escherichia coli in the past. Patients with diabetes mellitus are more likely to have a pyogenic liver abscess with gas forming infection; a gas forming pyogenic liver abscess carries a higher morbidity and mortality than the non-gas forming group. This study was conducted to clarify the clinical presentation and prognostic factors for pyogenic liver abscess in diabetic patients compared with non-diabetic patients. METHODS: Medical records of 140 cases of patients treated for pyogenic liver abscess from January 1995 through January 2004 were reviewed retrospectively in detail. RESULTS: Among 140 cases of pyogenic liver abscess, underlying diabetes was present in 26.4% (37/140). The clinical presentation between the two groups was not significantly different. The most common organism for the pyogenic abscess was K. pneumoniae in both groups. A gas forming liver abscess was discovered in only the diabetic liver abscess group, 6 of 37 patients (16%). CONCLUSIONS: K. pneumoniae was the most common organism cultured in both diabetic and non-diabetic liver abscess. Gas forming liver abscess was more common in diabetic patients than non-diabetic patients. Diabetic patients had more complications than non-diabetic patients.
Adult
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Aged
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*Diabetes Complications
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Female
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Humans
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Klebsiella Infections/complications
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Klebsiella pneumoniae
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Liver Abscess, Pyogenic/*complications/diagnosis/microbiology
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Male
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Middle Aged
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Prognosis
4.Comparison of Clinical Characteristics between Cryptogenic and Biliary Pyogenic Liver Abscess.
Hye Young CHOI ; Gab Jin CHEON ; Young Don KIM ; Koon Hee HAN ; Kwang Seok KIM ; Byung Kyu NAH
The Korean Journal of Gastroenterology 2007;49(4):238-244
BACKGROUND/AIMS: The aim of this study was to evaluate the characteristics of cryptogenic and biliary pyogenic liver abscess by comparing the clinical aspects between the two groups. METHODS: Of 119 patients treated for pyogenic liver abscess from 2000 to 2004, 82 subjects with cryptogenic liver abscess and 21 with biliary abscess were analysed retrospectively. RESULTS: There were no significant differences between the two groups regarding clinical symptoms. The characteristics of abscess were similar except the size of abscess. The size of abscess less than 5 cm in diameter was more common in billiary group than in cryptogenic group (p=0.004). Compare to cryptogenic group, biliary group had more positive culture test from abscess (100% vs. 69%, p=0.006). Especially, E. coli isolated from abscess culture (28% vs. 7%, p=0.014) and blood culcure (23% vs. 4%, p=0.035) were more common in biliary group than in cryptogenic group. There was no difference in mortality between the two groups (biliary vs. cryptogenic: 4.8% vs. 0%, p=0.204). However, the rate of clinical improvement was higher in cryptogenic group than in biliary group (92.7% vs. 66.7%, p=0.001). CONCLUSIONS: Biliary liver abscess had similar clinical characteristics to cryptogenic origin. Biliary liver abscess had smaller abscess size and more positive abscess culture rates than cryptogenic abscess. Improvement rate without complication and recurrence was higher in cryptogenic group than biliary group.
Aged
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Biliary Tract Diseases/*diagnosis
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Blood Chemical Analysis
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Female
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Gram-Negative Aerobic Bacteria/isolation & purification
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Gram-Positive Bacteria/isolation & purification
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Humans
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Liver Abscess, Pyogenic/*diagnosis/microbiology
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Male
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Middle Aged
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Retrospective Studies
5.Clinical Features of Pyogenic Liver Abscess according to Age Group.
Joo Ho PARK ; Tae Hee LEE ; Sung Tae KIM ; Jang Han JUNG ; Yong Seok KIM ; Sun Moon KIM ; Euyi Hyeog IM ; Kyu Chan HUH ; Young Woo CHOI ; Young Woo KANG
The Korean Journal of Gastroenterology 2010;56(2):90-96
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
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Age Factors
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Aged
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Aged, 80 and over
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Bacteria/isolation & purification
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Blood Cell Count
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Blood Chemical Analysis
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Female
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Humans
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Liver Abscess, Pyogenic/*diagnosis/microbiology/therapy
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Male
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Middle Aged
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Prognosis
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Retrospective Studies
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Sex Factors
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Urinalysis
6.Prevalence of and risk factors for endogenous endophthalmitis in patients with pyogenic liver abscesses.
In Hyung PARK ; Chung Hwan JUN ; Jin Woo WI ; Seon Young PARK ; Wan Sik LEE ; Sook In JUNG ; Chang Hwan PARK ; Young Eun JOO ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW
The Korean Journal of Internal Medicine 2015;30(4):453-459
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
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Anti-Bacterial Agents/administration & dosage
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Chi-Square Distribution
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Early Diagnosis
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Endophthalmitis/diagnosis/*epidemiology/microbiology/therapy
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Female
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Humans
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Intravitreal Injections
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Liver Abscess, Pyogenic/diagnosis/*epidemiology/microbiology
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Logistic Models
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Male
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Middle Aged
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Multivariate Analysis
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Odds Ratio
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Predictive Value of Tests
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Prevalence
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Republic of Korea/epidemiology
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Retrospective Studies
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Risk Factors
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Tomography, X-Ray Computed
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Treatment Outcome
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Visual Acuity
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Vitrectomy