Liver abscess

Content:

  • Definition
  • Types and causes
  • Symptoms of liver abscess
  • Treatment
  • Preventive measures

Define Liver abscess:

Liver abscess refers to accumulation of pus in the liver. It is due to infection or inflammation and remains confined to a specific region (liver) i.e., localised, rather then spreading throughout the body.

Types:

Liver is one of the most common organ to develop visceral abscess.

Liver can be classified as:

Pyogenic liver abscesses:

  • Caused by pus forming bacteria.
  • Constitutes 50 – 80% of the liver abscess cases.
  • This commonly involve intestinal bacteria such as Escherichia coli and Klebsiella pneumonia.
  • The infection is caused by one of the following:
  1. Bloodstream spread of the organism from a distant site.
  2. Local spread of the infection causing organism from the neighbouring site, such as biliary tract (most common source) or when the appendix is infected and it ruptures.

Amoebic liver abscess:

  • It is caused by a parasiti protozoa named Entamoeba histolytica.
  • Constitutes 10% of liver abscess cases.
  • The parasite may spread from large intestine to the liver by blood stream or direct infectious spread.
  • The characteristic feature of this abscess is the presence of Anchovy sauce pus in the liver. The Anchovy sauce pus is thick, chocolate brown in colour comprising dead liver cells without any pus cells and sometimes trophozoites (a growing stage of the Entamoeba histolytica) are also found in last few drops of the virus.

Fungal abscesses:

  • These are caused by Candida species.
  • They account for 10% of cases.

Symptoms of liver abscesses:

  • Fever with chills and rigors
  • Weightloss, nausea and vomiting
  • Sweating and weakness
  • Right upper quadrant pain
  • Tender hepatomegaly ( the liver becomes enlarged and causes pain and discomfort when the area is touched)
  • Very rarely jaundice and cough

Treatment for liver abscess:

  1. Generally, antibiotic and antiprotoxoals are effective in treating liver abscesses.
  2. However, aspiration (drawing out) of liver abscess contents become necessary, if there is a risk of abscess future or if the left lobe liver abscess grows > 10 cm or if there is no sign of improvement after the medication therapy for about a week.

Preventive measures:

The entry of these abscess causing organisms in the body primarily takes place by ingestion of contaminated food and water, so it should be avoided.

Also, asymptomatic persons should be treated, so as to prevent further spread of the disease.

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