Overview
Introduction
Liver Abscesses can result from bacterial infection (pyogenic abscess) or from Entamoeba Histolytica. Pyogenic abscesses have a high mortality rate of 40% .
Liver abscesses generally result from spread of infection from the digestive tract via the portal vein, from biliary disease or by direct extension from an adjacent infection.
Risk Factors
- Biliary disease
- Trauma
- Diabetes
- Malignancy.
Diagnosis Of Liver Abscess
Clinical
Pyogenic abscess can present acutely from systemic bacteraemia or biliary tract infection.
Sub-acute presentation often results from a single abscess from a localised infection: the patient may be admitted to hospital with the symptoms of the primary infection (eg. appendicitis).
Laboratory Diagnosis
Diagnostic investigations include:- Culture of aspirated material (under ultrasound guidance) is the most useful diagnostic test
- With the advent of modern systems and improved media, particularly for the recovery of anaerobic organisms, blood culture is often helpful.
Imaging
- CT is the most useful imaging technique, with ultrasound effective for lesions more than a couple of centimetres in diameter.
Signs And Symptoms
- Fever
- Anorexia
- Nausea
- Weight loss
- Weakness
- Upper right quadrant pain
- Jaundice is rare until a late stage of the infection.
Treatments For Liver Abscess
- Antibiotics
- Nitroimidazole
- Metronidazole
- Bed rest
- Fluids
Antibiotics :- Antibiotics is the general class of medications, including penicillin, that are used against bacteria and also some parasites. Antibiotics do not work against any viruses. The first ever discovered antibiotic was penicillin.
Metronidazole:- A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS.
Rest:- Freedom from physical activity.
Intravenous fluids: Injection of fluids into a vein to replace lost fluids.
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