liver abcess
TRANSCRIPT
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pyogenic
amebic
candidaTB
trauma
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oM > F 7:1o40-50 million amoeba infections/year worldwideoAge ExtremesoEndemic Areas most susceptibleoCountry of origin or Travel• Pregnancy• Steroids• Cancer• Endemic area travel
(short or long term)
Bacterial Most common M > F 3:1 Risk factor:
• DM• Cancer• Liver Transplant
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o Peritonitis To liver via portal circulation
o Direct Spreado Biliary infections
o Hematogenous Seedingo Bacteremia
o Sites: R lobe most commono Blood supply
:o Fecal-Oral transmission into GI Tract
To liver via portal circulationo Can also spread to other extraintestinal sites
o Hearto Braino Lungs
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ANTIBIOTIC• Pyogenic: Gram Neg + Anaerobe cov.
• Penisilin• Combination : 1. ampisilin+aminoglikoside• +sefalosprin 3th2. Sefalosporin 3th+klindamisin3. Metronidazol48-72 jam perbaikan - kultur
• Perenteral 10-14 hari, 6 minggu oral
• Amoeba: Metronidazol, tinidazol• 50 mg/kgBB 10 hari
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• Treated with drug and no clinical improvement occurs in 48 to 72 hour
• All large abscesses (especially those presenting as localised swellings or bulges of right lower thorax)
• Superficial abscess
• Abscesses causing severe pain or having marked tenderness or edema and abscess with mark elevation of the diafragma
early
• Impending perforation
• Cases with left lobe abscess
• Ruptuire into the pericardiac sac or peritoneal cavity
immediate
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