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INCIDENCE
Liver gets infected by Entamoeba histolytica commonly
The most common location of a pyogenic abscess is the
right lobe.
Chronic alcoholics - prone to get this infection
Entamoeba histolytica is endemic in many parts of the
world
PATHOPHYSIOLOGY
The amoebic cyst is ingested
Cyst develops into the trophozoite form in the colon
Reaches the liver through portal circulation
Pyogenic abscess may also occur due to the infection
by streptococcus milleri and Escherichia coli.
Many a time the pyogenic infection follows amoebic
infection
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CLINICAL FEATURES
Often the diagnosis of a bacterial abscess is
suggested clinically.
Fever
Pain right hypochondrium
Chills
Rigors
Toxicity
Right upper quadrant discomfort
Diarrhea
weight loss
Intercostal tendreness
Swelling in the right hypo chondrium or epigastrium
tender, enlarged liver.
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COMPLICATIONS:
Pneumonitis
Pleural effusion
Rupture of the liver abscess into the pleural cavity - causing
empyema
Rupture into the peritoneal cavity
TREATMENT
percutaneous or surgical drainage (Ultrasound guided repeated
aspiration)
antibiotics.
Metronidazole
Antibiotics like cephalosporins, aminoglycosides, tetracyclines
In rare cases it may need insertion of a drain.
mortality rate is almost 100% if the abscess remains untreated
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