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
    (Text) CC BY-SA