Recent Changes of Organism and Treatment in Pyogenic Liver Abscess

Korean J Hepatol > Volume 9(4); 2003 > Article

The Korean Journal of Hepatology 2003;9(4): 275-283.

Recent Changes of Organism and Treatment in Pyogenic Liver Abscess

Byung Kyu Nah, M.D.1, Yeon Soo Kim, M.D., Hee Seok Moon, M.D., Ki Oh Park, M.D., Sun Moon Kim, M.D., Yeum Seok Lee, M.D., Hyeon Woong Yang, M.D., Seung Weon Seo, M.D., Seok Hyun Kim, M.D., Byung Seok Lee, M.D., Nam Jae Kim, M.D. and Heon Young Lee, M.D.

Department of Internal medicine, Chungnam National University College of medicine, Daejeon, Korea, Department of Internal medicine, Gangneung Asan Hospital1, College of Medicine, University of Ulsan, Gangneung, Korea

ABSTRACT

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.(Korean J Hepatol 2003;12:275-283)

KeyWords: Liver abscess/pyogenic, Klebsiella pneumoniae