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Background/Aims: Although the epidemiology of pyogenic liver abscess (PLA) continues to change, only a few population‐based studies have been conducted in Korea. This study investigated the epidemiology and clinical outcomes of PLA patients during a period of 10 years. Methods: We analysed the Health Insurance Review and Assessment Service data between 2007 and 2017. The data included annual incidence rates, demographic data, underlying diseases, complications and mortality of PLA patients. Results: The annual incidence of PLA for all age groups was 10.9 per 100 000 population. The incidence was gradually increased from 5.7 per 100 000 in 2007 to 14.4 per 100 000 in 2017. In patients with liver abscess, the prevalence of diabetes and malignancy were 37.24% and 26.5% respectively. Metastatic infection was reported in 1.74% of the patients, and endophthalmitis was most common. The mean in‐hospital mortality was 9.6%, and there was no significant difference in mortality by year during the observation period. Mortality increased with age and was greatly affected by the underlying diseases, especially cancer. Based on the multivariate analysis results, the mortality of PLA patients was associated with older age, female sex, diabetes, malignancy and chronic kidney disease. Conclusion: The PLA incidence is rapidly increasing in Korea, especially in people with comorbidities. In addition, the causes and risk factors of PLA infections are changing and thus further research on epidemiology, different diagnosis and management approaches is required. [ABSTRACT FROM AUTHOR]

Background/aims: This study aimed to investigate the factors associated with prolonged hospital stay and in-hospital mortality in patients with pyogenic liver abscess.Methods: We retrospectively reviewed data from patients with pyogenic liver abscess who were admitted between 2005 and 2018 at three tertiary hospitals in Jeonbuk province, South Korea. Prolonged hospital stay was defined as a duration of hospital admission of more than 21 days.Results: A total of 648 patients (406 men and 242 women) diagnosed with pyogenic liver abscess were enrolled in the study. The mean maximal diameter of the liver abscess was 5.4 ± 2.6 cm, and 74.9% of the lesions were single. The three groups were divided according to the maximal diameter of the abscess. Laboratory parameters indicated a more severe inflammatory state and higher incidence of complications and extrahepatic manifestations with increasing abscess size. Rates of percutaneous catheter drainage (PCD) insertion, multiple PCD drainage, and salvage procedures as well as duration of drainage were also higher in the large liver abscess group. Of note, the duration of hospitalization and in-hospital mortality were significantly higher in the large hepatic abscess group. A multivariate analysis revealed that underlying diabetes mellitus, hypoalbuminemia, high baseline high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and large maximal abscess diameter were independent factors associated with prolonged hospital stay. Regarding in-hospital mortality, acute kidney injury at admission and maximal diameter of the abscess were independent factors associated with in-hospital mortality.Conclusions: A large maximal diameter of the liver abscess at admission indicated prolonged hospitalization and poor prognosis. More aggressive treatment strategies with careful monitoring are warranted in patients with large liver abscesses. [ABSTRACT FROM AUTHOR]

Purpose: To study the clinical features of endogenous endophthalmitis (EE) in sample patient populations from the USA and South Korea over an 8-year period.Methods: We reviewed data from 128 eyes of 60 American and 48 Korean patients diagnosed with EE and compared their clinical characteristics.Results: Fungemia and liver abscess were the most common extraocular infection sources among American (26.7%) and Korean patients (33.3%), respectively. Klebsiella pneumoniae and Candida species were the most common pathogens of EE in the Korean and the American patients, respectively. Endophthalmitis caused by fungi had a better visual prognosis than that caused by bacteria (p = 0.001). Vitrectomy was beneficial for eyes with EE due to virulent bacteria presenting with worse than counting finger vision.Conclusions: The predisposing conditions and responsible organisms for EE vary in different regions of the world. The visual prognosis was strongly influenced by the underlying pathogen. [ABSTRACT FROM AUTHOR]

배경: Fascioliasis, a food-borne helminth, is primarily a disease of cattle and sheep that occasionally occurs in humans. The aquatic perennial herb water dropwort (Oenanthe javanica) has been identified as the primary source of human infection in Korea. Recently, a cluster of patients who had not ingested water-dropwort, but instead had the use of a green vegetable delivery service in common were diagnosed with fascioliasis. Our study aimed to identify the association between the green vegetable juice delivery service and the occurrence of human fascioliasis. 방법: Patients with liver abscesses and eosinophilia were enrolled in this study. They were categorized as fascioliasis or non-fascioliasis according to the serology, clinical manifestation, and computed tomography or magnetic resonance imaging findings. Patients were classified as part of the fascioliasis group when ova or adult worms of the Fasciola species were detected or serology was positive with compatible clinical and radiological findings. 결과: We included 30 patients in this study; 15 were assigned to the fascioliasis group and the remaining 15 to the non-fascioliasis group. The proportion of patients who utilized the juice delivery service was significantly higher in the fascioliasis group than in the non-fascioliasis group (53.3% vs. 0%, P < 0.01). Most of the other patients in the fascioliasis group had known risk factors and intake of water dropwort or other raw vegetables. 결론: This study suggests that human fascioliasis could be transmitted by green vegetable juice produced and delivered by modern industrial systems. Further research on the product, industry, and the farm-level situation is required to validate these findings. [ABSTRACT FROM AUTHOR]

Background/Aims The epidemiology of pyogenic liver abscess (PLA) continues to change but few population-based studies have been conducted in Korea. This study investigated the epidemiology and clinical outcomes of PLA patients in current 5 years. Methods We used the Health Insurance Review and Assessment Service-National Patient Samples (HIRA-NPS) between 2012 and 2016. The HIRA-NPS, including approximately 1.4 million individuals, is a stratified random sample of 3% of the entire Korean population. The annual incidence rates, demographic data, underlying diseases, complications, and mortality rates were analyzed using the data. Results The annual incidence of PLA for all age groups increased gradually in Korea from 0.0273% (388 cases) in 2000 to 0.0298% (438 cases) in 2016. It occurred more commonly in male sex, and older age (>65 years). Among the 2,042 adult patients with PLA, 998 patients (48.9%) had diabetes mellitus, 108 patients (8%) colon cancer, and 346 patients (16.9%) biliary disease. Surgery due to PLA was in 44 patients (2.2%), and one patient (0.05%) received enucleation due to endogenous endophthalmitis. The mortality rate was 8.2%. In particular, the mortality rate was 13.4% in patients aged over 65 years and 19.3% over 85 years. Conclusions The incidence of PLA is increasing and the number of patients with comorbidity is also increasing. Especially, the mortality of PLA tend to increase in the old age. Further surveillance of epidemiology using National Health Insurance data is needed. [ABSTRACT FROM AUTHOR]

Background: There are limited studies focusing on liver abscess with negative microbiological cultures. This study evaluated the clinical and prognostic differences of patients with culture-negative liver abscess (CNLA) compared to those with a positive culture (CPLA) and compared these factors between K. pneumoniae liver abscess (KLA) and E. coli liver abscess (ELA).Methods: A retrospective study of the patients who admitted with a liver abscess at two tertiary hospitals in Korea from 2012 to 2016 was performed.Results: Among a total of 402 patients with liver abscess, 61.2% had positive cultures. K. pneumoniae (n = 133) was the most common cause, followed by E. coli (n = 74). Patients with CPLA were significantly older (p = 0.02) and more frequently had cholelithiasis or biliary tract disease (p = 0.001) compared to patients with CNLA. In-hospital mortality (p = 0.63) and recurrence (p = 0.77) were no different between the two groups. The length of hospital stay was significantly longer in patients with CPLA (p = 0.03) compared with those with CNLA. Subgroup analysis for patients who received 3rd generation cephalosporins empirically showed that in-hospital mortality (p = 0.18) and recurrence (p = 0.27) were not also significantly different. Cholelithiasis, or biliary tract disease (p = 0.001), liver disease (p = 0.001), malignancy (p = 0.0001), and ESBL production (p = 0.0001) were found more frequently in patients with ELA compared with those with KLA.Conclusions: The prognosis of the CNLA patients was similar to that of the CPLA patients, although the length of hospital stay was shorter in the CNLA patients. The epidemiologic and clinical characteristics of the ELA patients are somewhat different than those of the KLA patients. [ABSTRACT FROM AUTHOR]