Pyogenic Liver Abscess Flashcards
Liver abscesses are the most common type of ________and are usually due to a ______ that seeds an infection to the liver.
visceral abscess
recent abdominal inflammatory process (e.g., diverticulitis, cholangitis)
Liver abscesses most commonly involve the
_____ lobe of the liver because it is _______ than the left and caudate lobes.
right
larger and has greater blood supply
Patients with pyogenic liver abscess present with {cxfx}
fever and abdominal pain.
Pyogenic Liver Abscess. LBT results fot
WBC
AST/ALT
elevated in a nonspecific pattern.
Pyogenic Liver Abscess Medical Tx
Antibiotics to cover gram-negative bacteria and anaerobes e.g. 1st start with empiric Metro + cipro/ levo Metro + cefazidima / ceftriaxone Or Pip/tazo A carbapenem
Aspirate, culture and then treat accordingly!
Pyogenic Liver Abscess best test to diagnose
Ultrasound
Pyogenic Liver Abscess qx tx
Concurrent percutaneous aspiration is therapeutic.
Pyogenic Liver Abscess most common etiological agent
Enteric gram-negative bacilli
Pyogenic Liver Abscess most common etiological agent .. when there is colorectal CA/ hx of colonoscopy
Klebsiella pneumoniae— as it is normal intestinal flora. Such as bucal
Pyogenic Liver Abscess most common etiological agent .. when there is hx of transarterial embolization for HCC (hepatocellular CA)
Staphylococcus aureus—
Pyogenic Liver Abscess most common etiological agent .. during recovery of neutrophil counts after a neutropenic
episode
Candida
Pyogenic Liver Abscess most common etiological agent .. when there is hx of recent travel to Southeast Asia
Burkholderia pseudomallei—
Pyogenic Liver Abscess most common etiological agent .. when there is hx of recent travel to Central and South America and with diarrhea
E. histolytica—
