Harman Patil (Editor)

Pyogenic liver abscess

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Specialty
  
gastroenterology

ICD-9-CM
  
572.0

eMedicine
  
article/193182

ICD-10
  
K75.0

MedlinePlus
  
000261

MeSH
  
D046290

Pyogenic liver abscess

A pyogenic liver abscess is a type of liver abscess caused by bacteria.

Contents

Acute abscess

  • Fever
  • Lethargy
  • Discomfort in right upper quadrant of abdomen
  • Anorexia
  • Enlarged and tender liver
  • Pleural effusion
  • Chronic abscess

  • Fever
  • Abdominal discomfort
  • Enlarged liver
  • Cause

  • Biliary disease (most common)
  • E.g.: stones, cholangiocarcinoma

  • Colonic disease
  • E.g.: diverticulitis, appendicitis, Crohn's disease

  • Cryptogenic disease
  • Pancreatitis
  • Infection of blood
  • Intra-abdominal sepsis
  • Infection of biliary system
  • Traumatic introduction
  • E.g.: penetrating injury, iatrogenic (radiofrequency ablation)

    Common bacterial causes

  • Streptococcus milleri
  • E. coli
  • Streptococcus fecalis
  • Klebsiella pneumoniae
  • Proteus vulgaris
  • Bacteroides
  • Opportunistic pathogens (Staphylococcus)
  • Diagnosis

  • Blood CP (no leucocytosis)
  • Haemoglobin estimation (anaemia)
  • Serum albumin levels (falls rapidly)
  • USG and CT scanning
  • Guided aspiration to confirm the diagnosis
  • Treatment

    1. Antibiotics
    2. Penicillins
    3. Aminoglycosides
    4. Metronidazole
    5. Cephalosporins
    6. Percutaneous drainage under USG or CT control
    7. Laparotomy in intraabdominal disease

    References

    Pyogenic liver abscess Wikipedia


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