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- Title
Hepatic abscess: current approach to patients with pyogenic or amebic abscess.
- Authors
Pluta, Henryk; Pluta, Joanna N.
- Abstract
Liver abscess is caused by bacterial, amebic, or fungal infection. Generally, liver abscesses can be classified as pyogenic, amebic, or fungal. Pyogenic liver abscess (PLA) is a focal suppurative lesion within the liver tissue. It can occur either as a single or as multiple liver parenchyma lesions. Amebic liver abscess (ALA) is the most common form of liver abscess worldwide. The growing popularity of exotic travel destinations changes the distribution of ALA; it is becoming diagnosed more often outside its traditional zones in the tropical and subtropical regions, where amebiasis is common. Most PLAs are secondary to infection originating in the abdominal cavity. 30% of infections are caused by aerobic bacteria, 30% by anaerobic organisms, and around 40% by mixed aerobic and anaerobic bacteria. The most common causes of PLA today is cholangitis resulting from choledocholithiasis or bile duct strictures, followed by diverticulitis. Affected patients are usually seriously ill and present with abdominal pain, fever, rigors, and nocturnal sweating. Blood tests show leukocytosis, elevated acute phase reactants, hypoalbuminemia, and an abnormal liver function profile. Abdominal ultrasonography and computed tomography (CT) scan are very helpful, sensitive, and expeditious tests. Both techniques allow abscess drainage and are widely utilized. PLA treatment involves drainage and appropriate empirical broad-spectrum antibiotic coverage.
- Subjects
AMEBIC liver abscess; LIVER abscesses; AMEBIASIS; AEROBIC bacteria; ANAEROBIC bacteria; DIVERTICULITIS; LEUCOCYTOSIS
- Publication
Gastroenterologia Polska / Gastroenterology, 2008, Vol 15, Issue 5, p343
- ISSN
1232-9886
- Publication type
Article