| A clinical study on pyogenic liver abscesses: the changes in the clinical features during the recent 12 years |
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Jong Ha, Soon Pil Choi, Won Hyun Lee, Seung Suk Yoo, Hyun Jin Kim, Tae Hyo Kim, Ok Jae Lee |
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경희대학교 의과대학 순환기내과학교실 |
| 원저 : 최근 12년간의 화농성 간농양의 임상양상의 변화 |
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하 종 . 최순필 . 이원현 . 유승석 . 김현진 . 김태효 . 이옥재, Soon Pil Choi, Won Hyun Lee, Seung Suk Yoo, Hyun Jin Kim, Tae Hyo Kim, Ok Jae Lee |
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| Abstract |
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Background/Aims : The clinical features of pyogenic liver abscess have changed after the introduction of antimicrobial agents and intervention. This study was conducted to clarify the changes in the clinical features of pyogenic liver abscess during the recent 12 years.
Methods : We reviewed the medical records of 157 cases with pyogenic liver abscesses that were treated at our hospital between January 1995 and July 2006. The period was divided to 1 (1995-2000; 72 cases) and 2 (2001-July 2006; 85 cases).
Results : Prevalence of patients with an age over 70 increased significantly in period 2 compared to period 1 (p=0.019). The biliary tract was the most common portal of entry during the 12 years, and biliary procedures were the important causative factors. Compared to the non-biliary group, the biliary group was older and it had a higher frequency of recurrent abscess, Escherichia coli infection, and air-biliary gram (p<0.05). Klebsiella pneumoniae was the most common pathogen, and the frequency of E. coli was increased in period 2 compared to period 1 (p=0.045). Only 6.9% and 1.2% of the patients during period 1 and 2, respectively, were treated surgically. The overall mortality was 0.6% (0% vs. 1.2%, respectively). The interval from onset to admission, the size of the abscess cavity, the time to defervescence and the hospital stay were shorter in period 2 than in period 1 (p=0.044, p=0.013, p=0.02 and p=0.0002, respectively).
Conclusions : Recently, pyogenic liver abscess affects the elderly, and biliary procedures are its important causative factor. E. coli is still a common pathogen in relation to the biliary portal of entry. The elderly patients with biliary problems need better medical attention to avoid the development of pyogenic liver abscess, and for making an early diagnosis and achieving a better outcome. (Korean J Med 74:37-50, 2008)
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| Key Words:
Pyogenic; Liver abscess; Elderly; Biliary; Klebsiella pneumoniae; Escherichia coli |
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