Liver Abscesses + Cysts

Question 1

def

Answer 1

liver infection resulting in a walled off collection of pus or cyst fluid

Question 2

aetiology

Answer 2

1 pyogenic (80%)
-E. coli, Klebsiellae, enterococci, streptococci, staphylococci (biliary tract sepsis)
-60% by biliary tract disease (gallstones)
2 amoebic
-secondary entamoeba histolytica infection
3 hydatid cyst
-tapeworm echinococcus
4 fungal
-candida albicans
-aspergillus
5 TB

Question 3

what are fungal causes of liver abscesses associated with

Answer 3

antibiotics
transplantation
immunosuppression or immunodeficicency

Question 4

epi

Answer 4

pyogenic
-0.8/100,000PA
-60yrs
-most common in developed world
ameobic is most common worldwide

Question 5

history

Answer 5

1 fever, night sweats, malaise
2 RUQ/epigastric pain
3 jaundice
4 diarrhoea

Question 6

why might someone with a liver abscess get hiccups

Answer 6

diaphragmatic irritation

Question 7

why might someone with RUQ/epigastric pain have referred pain in their shoulder

Answer 7

diaphragmatic irritation

Question 8

examination

Answer 8

1 fevers
2 jaundice
3 tender hepatomegaly
4 dull percussion + decreased breath sounds at right base of lung

Question 9

investigations

Answer 9

1 bloods
-FBC (mild anaemia, high WCC, high eosinophils in hydatid disease)
-LFTs (high bilirubin)
-high ESR + CRP
-amoebic + hydatid serology
2 stool microscopy cultures
-for e. histolytica or tapeworm eggs
3 USS

Question 10

why are there decreased breath sounds at right base of lung

Answer 10

reactive pleural effusion