The Evolving Nature of Hepatic Abscess: A Review

Mavilia, Marianna G.; Molina, Marco; Wu, George Y.

doi:10.14218/jcth.2016.00004

Cited by 65 publications

(71 citation statements)

References 55 publications

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“…With regard to epidemiologic characteristics, our findings in elderly patients were also consistent with the literature, with a predominance of women in the older group and men in the younger group [8, 21, 22]. This may be due to the different life expectancies between sexes as well as the greater prevalence of chronic liver disease among younger patients in our study.…”

Section: Discussionsupporting

confidence: 91%

Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study

et al. 2017

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BackgroundTo analyse the clinical, epidemiological, microbiological and prognostic differences of pyogenic liver abscess (PLA) in older (≥ 65 years of age) versus younger patients (< 65 years).MethodsMulticentre, retrospective cohort study in all patients with PLA admitted to two Spanish hospitals from January 2000 to January 2014. Cases were divided into two age groups (< 65 years and ≥65 years) for comparison of clinical, epidemiological and microbiological characteristics as well as treatment.ResultsOf 98 patients analysed, 40 patients were younger than 65, and 58 were aged 65 or older. Significant associations in the older group were found with female sex (adjusted odds ratio [ORa] 9.0; 95% CI 1.4, 56), non-cryptogenic origin (ORa 14.5; 95% CI 1.6, 129), absence of chronic liver disease (ORa 14; 95% CI 1.3, 155), Escherichia coli infection (ORa 7.7; 95% CI 1.03, 58), and incidence of complications (ORa 2.3; 95% CI 1.04, 5.4). Mortality was 8.2% overall, although all deaths occurred in the older group (8/58; 13.8%) (p = 0.02).DiscussionOur results are in consonance with other published studies. Older patients with PLA tend to present more anomalies in the biliary tract (Kai et. al, World J Gastroenterol 18: 2948-295, 2012, Rahimian et. al, Clin Infect Dis 39:1654-9, 2004, Seeto, Medicine (Baltimore) 75:99-113, 1996, Kao et.al, Aliment Pharmacol Ther 36:467-76, 2012, Lai et. al, Gastroenterology 146:129-37, 2014), while younger patients are more often male and present more commonly with previous liver disease (especially related to alcohol) and cryptogenic PLA.ConclusionIn patients aged 65 or older, PLA was more common in women and in those with a history of biliary disease, and E. coli was the most frequent bacterium. Mortality was also higher in the older group.

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Section: Discussionsupporting

confidence: 91%

Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study

et al. 2017

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“…Pyogenic liver abscesses are usually classified by presumed route of hepatic invasion: (1) biliary tree, (2) portal vein, (3) hepatic artery, and (4) direct extension from contiguous focus of infection ( Fig. 1 ) [ 8 ]. The most common etiologies are unknown cryptogenic (primary) origin and infection by biliary route [ 9 10 ].…”

Section: Route Of Hepatic Invasionmentioning

confidence: 99%

Klebsiella pneumoniaeLiver Abscess

Jun

2018

Infect Chemother

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Since the mid 1980s, the prevalence of liver abscess caused by hypervirulent Klebsiella pneumoniae strain has increased in Asia, particularly in Taiwan and Korea. This strain is mostly K1 or K2 serotype, and has hypercapsular and hypermucoid phenotypes. Most infections are community acquired, and patients rarely have a hepatobiliary disease prior to infection. Clinical manifestations are characterized by fever and high C-reactive protein, and metastatic infections, such as septic emboli in the lung and endophthalmitis and meningitis are frequently observed. Antibiotic resistance is rare. Antibiotic treatment and abscess drainage are needed, and early diagnosis and treatment of endophthalmitis is also important.

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“…It was reported that liver biopsy could be considered to obtain liver tissue sample for bacterial culturing, however, it is not easy to perform in children owing to its invasiveness. Some rare diagnostic methods include: bile culture is invasive, and liver puncture is not guaranteed to take bile unless there is a definite bile lake (15).…”

Section: Discussionmentioning

confidence: 99%

Intravenous antibiotics for the treatments of cholangitis after Kasai operation in biliary atresia patients

Wang¹,

Li²,

Jiao³

et al. 2020

Preprint

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Objective: This is a single-center, retrospective study, to assess the experimental treatment of intravenous antibiotics for cholangitis after Kasai portoenterostomy (PKE) in biliary atresia (BA) patients.Methods: 153 cholangitis patients after PKE from January 2016 to December 2018 were retrospectively reviewed. Based on the different kinds of antibiotics treatment, all patients were divided into 3 groups: Intravenous Cefoperazone Sodium Tazobactam Sodium (ICSTS) group, Intravenous Meropenem (IMP) group, Meropenem combined with Intravenous immunoglobulin (IVIG) group, compared the tre atment effect among 3 groups.Results: The recurrent cholangitis rate of ICSTS group, IMP group and IVIG group is 28.9%,39.4%, 85.7% respectively. The IVIG group had higher temperature (T), white blood cell (WBC), C-reactive protein (CRP), alanine transaminase (ALT) and aspartate transaminase (AST) lever than ICSTS group and IMP group (P <0.05) before interference. The antifebrile rate had no significant difference among 3 groups after 3 days hospitalization, as we expected, the level of WBC, CRP, DBL was significant descend in each group, the level of ALT, AST, γ-GGT was obviously decline in IVIG group. After 3 months followed-up, IVIG group showed a recurrent rate of 82%, which was higher than ICSTS group and IMP group (P=0.013), the cholangitis frequency was significant higher in IVIG group than ICSTS group and IMP group (P<0.05).Conclusions: Personalized intravenous antibiotics to treat cholangitis considering recurrent episode, the severity of infection and liver function, may be a more appropriate treatment strategy.

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The Evolving Nature of Hepatic Abscess: A Review

Cited by 65 publications

References 55 publications

Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study

Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study

Klebsiella pneumoniaeLiver Abscess

Intravenous antibiotics for the treatments of cholangitis after Kasai operation in biliary atresia patients

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