Skip to main content
Top
Published in: BMC Infectious Diseases 1/2019

Open Access 01-12-2019 | Cholelithiasis | Research article

Comparison of clinical characteristics and outcomes of pyogenic liver abscess patients < 65 years of age versus ≥ 65 years of age

Authors: Jia Zhang, Zhaoqing Du, Jianbin Bi, Zheng Wu, Yi Lv, Xufeng Zhang, Rongqian Wu

Published in: BMC Infectious Diseases | Issue 1/2019

Login to get access

Abstract

Background

Pyogenic liver abscess (PLA) in the elderly is insufficiently elucidated. A few studies attempted to investigate the role of age in PLA have yielded controversial results. The purpose of this study was to explore the possible differences in the comorbidity, microbiological characteristics and clinical course between elderly and young PLA patients.

Methods

The clinical data of 332 adult PLA patients who received treatment at our hospital from January 2010 to December 2016 were collected. The demographic data, etiologies, comorbidities, clinical features, laboratory results, imaging findings, microbiological characteristics, choices of treatment and clinical outcomes were analyzed.

Results

Eighty-two (24.7%) patients were older than 65 years. Comorbidities including hypertension, diabetes mellitus, and cholelithiasis were more frequently found in older patients. Elderly PLA patients were more likely to present with atypical symptoms and signs on admission. The laboratory abnormalities and imaging findings were similar between the two groups. Klebsiella pneumonia was the most common pathogen on pus culture in both groups. There were no statistically significant differences in choices of treatment, PLA-related complications and length of in-hospital stay between the two groups. And there was no in-hospital mortality.

Conclusions

The clinical characteristics were similar in young and elderly PLA patients. However, elderly PLA patients were more likely to have underlying diseases and tended to have atypical presentations. Physicians need to be vigilant when encounter possible elderly patients with PLA. However, older PLA patients had comparable outcomes as their younger counterparts. With effective treatment, both elderly and young PLA patients can be cured.
Literature
1.
go back to reference Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med. 2006;34(1):15–21.CrossRef Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med. 2006;34(1):15–21.CrossRef
2.
go back to reference Chen XC, Yang YF, Wang R, Gou HF, Chen XZ. Epidemiology and microbiology of sepsis in mainland China in the first decade of the 21st century. Int J Infect Dis. 2015;31:9–14.CrossRef Chen XC, Yang YF, Wang R, Gou HF, Chen XZ. Epidemiology and microbiology of sepsis in mainland China in the first decade of the 21st century. Int J Infect Dis. 2015;31:9–14.CrossRef
3.
go back to reference Meddings L, Myers RP, Hubbard J, Shaheen AA, Laupland KB, Dixon E, Coffin C, Kaplan GG. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105(1):117–24.CrossRef Meddings L, Myers RP, Hubbard J, Shaheen AA, Laupland KB, Dixon E, Coffin C, Kaplan GG. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105(1):117–24.CrossRef
4.
go back to reference Tsai FC, Huang YT, Chang LY, Wang JT. Pyogenic liver abscess as endemic disease, Taiwan. Emerg Infect Dis. 2008;14(10):1592–600.CrossRef Tsai FC, Huang YT, Chang LY, Wang JT. Pyogenic liver abscess as endemic disease, Taiwan. Emerg Infect Dis. 2008;14(10):1592–600.CrossRef
5.
go back to reference Wi JW, Cho EA, Jun CH, Park SY, Park CH, Joo YE, Kim HS, Choi SK, Rew JS, Jung SI. Clinical characteristics and outcomes of pyogenic liver abscess in elderly Korean patients. Korean J Gastroenterol. 2015;66(1):27–32.CrossRef Wi JW, Cho EA, Jun CH, Park SY, Park CH, Joo YE, Kim HS, Choi SK, Rew JS, Jung SI. Clinical characteristics and outcomes of pyogenic liver abscess in elderly Korean patients. Korean J Gastroenterol. 2015;66(1):27–32.CrossRef
6.
go back to reference Law ST, Li KK. Older age as a poor prognostic sign in patients with pyogenic liver abscess. Int J Infect Dis. 2013;17(3):e177–84.CrossRef Law ST, Li KK. Older age as a poor prognostic sign in patients with pyogenic liver abscess. Int J Infect Dis. 2013;17(3):e177–84.CrossRef
7.
go back to reference Chen SC, Lee YT, Yen CH, Lai KC, Jeng LB, Lin DB, Wang PH, Chen CC, Lee MC, Bell WR. Pyogenic liver abscess in the elderly: clinical features, outcomes and prognostic factors. Age Ageing. 2009;38(3):271–6 discussion.CrossRef Chen SC, Lee YT, Yen CH, Lai KC, Jeng LB, Lin DB, Wang PH, Chen CC, Lee MC, Bell WR. Pyogenic liver abscess in the elderly: clinical features, outcomes and prognostic factors. Age Ageing. 2009;38(3):271–6 discussion.CrossRef
8.
go back to reference Kang SC, Hwang SJ. Impact of advanced age on inpatients with pyogenic liver abscess in Taiwan: a nationwide claim-based analysis. J Chin Med Assoc. 2011;74(12):539–43.CrossRef Kang SC, Hwang SJ. Impact of advanced age on inpatients with pyogenic liver abscess in Taiwan: a nationwide claim-based analysis. J Chin Med Assoc. 2011;74(12):539–43.CrossRef
9.
go back to reference Alvarez JA, Gonzalez JJ, Baldonedo RF, Sanz L, Junco A, Rodrfiguez JL, Martinez MD. Pyogenic liver abscesses: a comparison of older and younger patients. HPB (Oxford). 2001;3(3):201–6.CrossRef Alvarez JA, Gonzalez JJ, Baldonedo RF, Sanz L, Junco A, Rodrfiguez JL, Martinez MD. Pyogenic liver abscesses: a comparison of older and younger patients. HPB (Oxford). 2001;3(3):201–6.CrossRef
10.
go back to reference Smoger SH, Mitchell CK, McClave SA. Pyogenic liver abscesses: a comparison of older and younger patients. Age Ageing. 1998;27(4):443–8.CrossRef Smoger SH, Mitchell CK, McClave SA. Pyogenic liver abscesses: a comparison of older and younger patients. Age Ageing. 1998;27(4):443–8.CrossRef
11.
go back to reference Peris J, Bellot P, Roig P, Reus S, Carrascosa S, Gonzalez-Alcaide G, Palazon JM, Ramos JM. Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study. BMC Geriatr. 2017;17(1):161.CrossRef Peris J, Bellot P, Roig P, Reus S, Carrascosa S, Gonzalez-Alcaide G, Palazon JM, Ramos JM. Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study. BMC Geriatr. 2017;17(1):161.CrossRef
12.
go back to reference Zhang J, Du Z, Bi J, Wu Z, Lv Y, Zhang X, Wu R. The impact of previous abdominal surgery on clinical characteristics and prognosis of pyogenic liver abscess: a 10-year retrospective study of 392 patients. Medicine (Baltimore). 2018;97(39):e12290.CrossRef Zhang J, Du Z, Bi J, Wu Z, Lv Y, Zhang X, Wu R. The impact of previous abdominal surgery on clinical characteristics and prognosis of pyogenic liver abscess: a 10-year retrospective study of 392 patients. Medicine (Baltimore). 2018;97(39):e12290.CrossRef
13.
go back to reference Kawasaki T, Chaudry IH. The effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 2: liver, intestine, spleen, and kidney. J Anesth. 2012;26(6):892–9.CrossRef Kawasaki T, Chaudry IH. The effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 2: liver, intestine, spleen, and kidney. J Anesth. 2012;26(6):892–9.CrossRef
14.
go back to reference Kawasaki T, Chaudry IH. The effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 1: central nervous system, lung, and heart. J Anesth. 2012;26(6):883–91.CrossRef Kawasaki T, Chaudry IH. The effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 1: central nervous system, lung, and heart. J Anesth. 2012;26(6):883–91.CrossRef
15.
go back to reference Weniger M, Angele MK, Chaudry IH. The role and use of estrogens following trauma. Shock. 2016;46(3 Suppl 1):4–11.CrossRef Weniger M, Angele MK, Chaudry IH. The role and use of estrogens following trauma. Shock. 2016;46(3 Suppl 1):4–11.CrossRef
16.
go back to reference Klein SL, Jedlicka A, Pekosz A. The Xs and Y of immune responses to viral vaccines. Lancet Infect Dis. 2010;10(5):338–49.CrossRef Klein SL, Jedlicka A, Pekosz A. The Xs and Y of immune responses to viral vaccines. Lancet Infect Dis. 2010;10(5):338–49.CrossRef
17.
go back to reference Aulock SV, Deininger S, Draing C, Gueinzius K, Dehus O, Hermann C. Gender difference in cytokine secretion on immune stimulation with LPS and LTA. J Interf Cytokine Res. 2006;26(12):887–92.CrossRef Aulock SV, Deininger S, Draing C, Gueinzius K, Dehus O, Hermann C. Gender difference in cytokine secretion on immune stimulation with LPS and LTA. J Interf Cytokine Res. 2006;26(12):887–92.CrossRef
18.
go back to reference Couto Dde O, Peixoto Junior AA, Farias JL, Sales Dde B, Lima JP, Rodrigues RS, Meneses FA. Gender and mortality in sepsis: do sex hormones impact the outcome? Rev Bras Ter Intensiva. 2011;23(3):297–303.CrossRef Couto Dde O, Peixoto Junior AA, Farias JL, Sales Dde B, Lima JP, Rodrigues RS, Meneses FA. Gender and mortality in sepsis: do sex hormones impact the outcome? Rev Bras Ter Intensiva. 2011;23(3):297–303.CrossRef
19.
go back to reference Angele MK, Pratschke S, Hubbard WJ, Chaudry IH. Gender differences in sepsis: cardiovascular and immunological aspects. Virulence. 2014;5(1):12–9.CrossRef Angele MK, Pratschke S, Hubbard WJ, Chaudry IH. Gender differences in sepsis: cardiovascular and immunological aspects. Virulence. 2014;5(1):12–9.CrossRef
20.
go back to reference Choudhry MA, Bland KI, Chaudry IH. Trauma and immune response--effect of gender differences. Injury. 2007;38(12):1382–91.CrossRef Choudhry MA, Bland KI, Chaudry IH. Trauma and immune response--effect of gender differences. Injury. 2007;38(12):1382–91.CrossRef
21.
go back to reference Choudhry MA, Bland KI, Chaudry IH. Gender and susceptibility to sepsis following trauma. Endocr Metab Immune Disord Drug Targets. 2006;6(2):127–35.CrossRef Choudhry MA, Bland KI, Chaudry IH. Gender and susceptibility to sepsis following trauma. Endocr Metab Immune Disord Drug Targets. 2006;6(2):127–35.CrossRef
22.
go back to reference Sener G, Arbak S, Kurtaran P, Gedik N, Yegen BC. Estrogen protects the liver and intestines against sepsis-induced injury in rats. J Surg Res. 2005;128(1):70–8.CrossRef Sener G, Arbak S, Kurtaran P, Gedik N, Yegen BC. Estrogen protects the liver and intestines against sepsis-induced injury in rats. J Surg Res. 2005;128(1):70–8.CrossRef
23.
go back to reference Angele MK, Wichmann MW, Ayala A, Cioffi WG, Chaudry IH. Testosterone receptor blockade after hemorrhage in males. Restoration of the depressed immune functions and improved survival following subsequent sepsis. Arch Surg. 1997;132(11):1207–14.CrossRef Angele MK, Wichmann MW, Ayala A, Cioffi WG, Chaudry IH. Testosterone receptor blockade after hemorrhage in males. Restoration of the depressed immune functions and improved survival following subsequent sepsis. Arch Surg. 1997;132(11):1207–14.CrossRef
24.
go back to reference Qian Y, Wong CC, Lai S, Chen H, He X, Sun L, Wu J, Zhou J, Yu J, Liu W, et al. A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015. Sci Rep. 2016;6:38587.CrossRef Qian Y, Wong CC, Lai S, Chen H, He X, Sun L, Wu J, Zhou J, Yu J, Liu W, et al. A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015. Sci Rep. 2016;6:38587.CrossRef
25.
go back to reference Du ZQ, Zhang LN, Lu Q, Ren YF, Lv Y, Liu XM, Zhang XF. Clinical Charateristics and outcome of pyogenic liver abscess with different size: 15-year experience from a single center. Sci Rep. 2016;6:35890.CrossRef Du ZQ, Zhang LN, Lu Q, Ren YF, Lv Y, Liu XM, Zhang XF. Clinical Charateristics and outcome of pyogenic liver abscess with different size: 15-year experience from a single center. Sci Rep. 2016;6:35890.CrossRef
26.
go back to reference Luo M, Yang XX, Tan B, Zhou XP, Xia HM, Xue J, Xu X, Qing Y, Li CR, Qiu JF, et al. Distribution of common pathogens in patients with pyogenic liver abscess in China: a meta-analysis. Eur J Clin Microbiol Infect Dis. 2016;35(10):1557–65.CrossRef Luo M, Yang XX, Tan B, Zhou XP, Xia HM, Xue J, Xu X, Qing Y, Li CR, Qiu JF, et al. Distribution of common pathogens in patients with pyogenic liver abscess in China: a meta-analysis. Eur J Clin Microbiol Infect Dis. 2016;35(10):1557–65.CrossRef
27.
go back to reference Keller JJ, Tsai MC, Lin CC, Lin YC, Lin HC. Risk of infections subsequent to pyogenic liver abscess: a nationwide population-based study. Clin Microbiol Infect. 2013;19(8):717–22.CrossRef Keller JJ, Tsai MC, Lin CC, Lin YC, Lin HC. Risk of infections subsequent to pyogenic liver abscess: a nationwide population-based study. Clin Microbiol Infect. 2013;19(8):717–22.CrossRef
28.
go back to reference Lardiere-Deguelte S, Ragot E, Amroun K, Piardi T, Dokmak S, Bruno O, Appere F, Sibert A, Hoeffel C, Sommacale D, et al. Hepatic abscess: diagnosis and management. J Visc Surg. 2015;152(4):231–43.CrossRef Lardiere-Deguelte S, Ragot E, Amroun K, Piardi T, Dokmak S, Bruno O, Appere F, Sibert A, Hoeffel C, Sommacale D, et al. Hepatic abscess: diagnosis and management. J Visc Surg. 2015;152(4):231–43.CrossRef
29.
go back to reference Ruiz-Hernandez JJ, Leon-Mazorra M, Conde-Martel A, Marchena-Gomez J, Hemmersbach-Miller M, Betancor-Leon P. Pyogenic liver abscesses: mortality-related factors. Eur J Gastroenterol Hepatol. 2007;19(10):853–8.CrossRef Ruiz-Hernandez JJ, Leon-Mazorra M, Conde-Martel A, Marchena-Gomez J, Hemmersbach-Miller M, Betancor-Leon P. Pyogenic liver abscesses: mortality-related factors. Eur J Gastroenterol Hepatol. 2007;19(10):853–8.CrossRef
30.
go back to reference Cerwenka H. Pyogenic liver abscess: differences in etiology and treatment in Southeast Asia and Central Europe. World J Gastroenterol. 2010;16(20):2458–62.CrossRef Cerwenka H. Pyogenic liver abscess: differences in etiology and treatment in Southeast Asia and Central Europe. World J Gastroenterol. 2010;16(20):2458–62.CrossRef
Metadata
Title
Comparison of clinical characteristics and outcomes of pyogenic liver abscess patients < 65 years of age versus ≥ 65 years of age
Authors
Jia Zhang
Zhaoqing Du
Jianbin Bi
Zheng Wu
Yi Lv
Xufeng Zhang
Rongqian Wu
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Cholelithiasis
Published in
BMC Infectious Diseases / Issue 1/2019
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-019-3837-2

Other articles of this Issue 1/2019

BMC Infectious Diseases 1/2019 Go to the issue