Liver abscess
Template:Infobox medical condition (new) A liver abscess is a mass filled with pus inside the liver.[1] Common causes are abdominal conditions such as appendicitis or diverticulitis due to haematogenous spread through the portal vein.[2] It can also develop as a complication of a liver injury.
Causes
Risk factors for developing liver abscess can be due to infection, post-procedural infection and metastasis such as primary liver tumours, liver metastasis, biliary procedures, biliary injuries, biliary tract disease, appendicitis, and diverticulitis.[3]
Major bacterial causes of liver abscess include the following:[4]
- Streptococcus species (including Enterococcus)
- Escherichia species
- Staphylococcus species
- Klebsiella species (Higher rates in the Far East)
- Anaerobes (including Bacteroides species)
- Pseudomonas species
- Proteus species
- Entamoeba histolytica
However, as noted above, many cases are polymicrobial.
Diagnosis
Types
There are several major forms of liver abscess, classified by cause:[3]
- Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States.
- Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases. The incidence is much higher in developing countries.
- Fungal abscess, most often due to Candida species, accounts for less than 10% of cases.
- Iatrogenic abscess, caused by medical interventions
Management
Draining of the abscess and antibiotics: IV metronidazole and third generation cephalosporin/quinolones, β-lactam antibiotics, and aminoglycosides are effective.[3]
Prognosis
The prognosis has improved for liver abscesses. The mortality rate in-hospital is about 2.5-19%. The elderly, ICU admissions, shock, cancer, fungal infections, cirrhosis, chronic kidney disease, acute respiratory failure, severe disease, or disease of biliary origin have a worse prognosis.[5]
References
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- ↑ MedlinePlus Encyclopedia: Pyogenic liver abscess
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External links
- Liver Abscess CT Images CTCases Liver Abscess CT Scan.
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