Liver abscesses

Question 1

What is a liver abscess?

Answer 1

Liver abscesses are purulent collections in the liver parenchyma that result from bacterial, fungal, or parasitic infection.

Question 2

What are the risk factors of a liver abscess?

Answer 2

Biliary tract disease
Age >50
underlying malignancy
DM
Interventional biliary or hepatic procedures
Living in or visiting areas for amoebiasis

Question 3

What is the epidemiology of a liver abscess?

Answer 3

Liver abscess is an uncommon disease. The annual incidence is approximately 3.6 per 100,000 in the US and the UK

Question 4

What are the signs and symptoms of a liver abscess?

Answer 4

Fever/ chills
RUQ tenderness
Hepatomegaly
Weight loss
fatigue
Abdominal pain
Nausea and vomiting
Cough, SOB, chest pain

Question 5

What investigations might you use for a liver abscess?

Answer 5

Bloods:
> FBC (infection markers)
> Serum LFTs (elevated alk phos, aminotransferases, BR and hypobilirubinaemia)
> Blood Cultures
> PT and aPTT (clotting)

Liver US

Contrast enhanced CT

Gram stain and culutre of abscess fluid aspirate