Lesson 1.4 - Liver Bacterial and Parasitic Disease Flashcards
How does pyogenic bacteria reach the liver (3)
travels via Biliary tract*
travels via Portal veins*
travels via Hepatic artery
Hepatic abcesses are mainly caused by
bacterial infection
Presenting features of pyogenic liver absess (6)
fever malaise anorexia RUQ pain jaundice leukocytosis
purulent means
containing pus
supperation
process of forming pus
T/F
abcesses vary in echogenicity and contour
True
Fluid ranges from echo free to highly echogenic
Walls can be thick, irregular or well defined
Gas producing organisms give rise to
echogenic foci with posterior reverberation artifacts
What confirms the diagnosis of an abcess
US guided needle aspiration
Liver abcess differential diagnosis (4)
Amebic/echinococcal infection
Simple cyst with hemorrhage
Necrotic or cystic neoplasm
Hematoma
Candidiasis is what type of disease and happens most commonly in what type of patients
Fungal disease
immunosuppressed patients
Immunosuppressed patients
pre/post transplant cancer chemotherapy/radiation AIDS/HIV inherited disease - blood disorders underlying systemic infection poor nutrition
Different US features of candidiasis
uniformly hypoechoic*
bulls eye (hypo rim, hyper centre)
wheel within a wheel (hypo, echogenic, hypo central nidus)
hyperechoic foci - multiple small abcesses with air (pic)
Parasitic liver diseases (4)
Amebiasis
Hydatid (echinococcal) disease
Schistosomiasis
Pneumocystis carinii
Most common presenting symptom of amebiasis
pain
Hydatid (echinococcal) disease most commonly affects which lobe and what does it form?
right lobe
forms slow growing cysts
Which parasitic disease looks like a waterlily sign
Hydatid (echinococcal) disease
What is the most common parasitic infection in humans
Schistosomiasis
What happens with schistosomiasis
PV occulsion
Initially hepatomegaly then liver shrinks, portal hypertension prevails
Schistosomiasis sono features
Widened echogenic portal tracts - up to 2 cm
Dilated biliary ducts
Schistosomiasis leads to (4)
portal hypertension
splenomegaly
varices
ascites
Sono appearance of pneumocystis carinii
Tiny diffuse nonshadowing echogenic foci
or echogenic clumps of dense calcification
Parasitic disease all get to liver via the
portal vein
List 2 most common causes of bacterial disease via the portal venous system
diverticulitis
appendicitis
List 2 most common causes of bacterial disease via the hepatic artery
osteomyelitis
bacterial endocarditis
