Liver abscess: Difference between revisions
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| + | == Background == |
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| + | === Microbiology === |
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| + | * Pyogenic |
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| + | ** [[Gram-negative bacteria]] |
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| + | *** ''[[Escherichia coli]]'' |
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| + | *** [[Klebsiella species]] |
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| + | *** Less common: ''[[Pseudomonas aeruginosa]]'', ''[[Proteus]]'', ''[[Enterobacter]]'', ''[[Citrobacter]]'', and ''[[Serratia]]'' |
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| + | ** [[Gram-positive bacteria]] |
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| + | *** [[Streptococcus species]], especially ''anginosus'' group |
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| + | *** [[Enterococcus species]] |
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| + | *** Other [[Viridans group streptococci]] |
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| + | *** Less common ''[[Staphylococcus aureus]]'' and ''[[Streptococcus pyogenes]]'' |
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| + | ** [[Anaerobes]] |
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| + | *** [[Bacteroides species]] |
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| + | *** Less common: [[Fusobacterium]], anaerobic streptococci, [[Clostridium species]], ''[[Lactobacillus]]'' |
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| + | * Amebic |
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| + | ** ''[[Entamoeba histolytica]]'' |
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| + | |||
| + | === Etiology === |
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| + | * Pyogenic |
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| + | ** '''Biliary:''' most common mechanism, includes ascending cholangitis |
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| + | ** '''Hematogenous via hepatic artery:''' from bacteremia |
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| + | ** '''Hematogenous via portal vein:''' from an infection abdominal organ duch as diverticulitis, pancreatitis, or appendicitis |
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| + | ** '''Contiguous spread''' |
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| + | ** '''Trauma:''' including things like ingested toothpicks |
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| + | ** '''Cryptogenic''': second most common mechanism is "unknown" |
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| + | * Amebic: see ''[[Entamoeba histolytica]]'' |
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| + | |||
== Management == |
== Management == |
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* Get source control |
* Get source control |
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Revision as of 17:32, 13 February 2020
Background
Microbiology
- Pyogenic
- Gram-negative bacteria
- Escherichia coli
- Klebsiella species
- Less common: Pseudomonas aeruginosa, Proteus, Enterobacter, Citrobacter, and Serratia
- Gram-positive bacteria
- Streptococcus species, especially anginosus group
- Enterococcus species
- Other Viridans group streptococci
- Less common Staphylococcus aureus and Streptococcus pyogenes
- Anaerobes
- Bacteroides species
- Less common: Fusobacterium, anaerobic streptococci, Clostridium species, Lactobacillus
- Gram-negative bacteria
- Amebic
Etiology
- Pyogenic
- Biliary: most common mechanism, includes ascending cholangitis
- Hematogenous via hepatic artery: from bacteremia
- Hematogenous via portal vein: from an infection abdominal organ duch as diverticulitis, pancreatitis, or appendicitis
- Contiguous spread
- Trauma: including things like ingested toothpicks
- Cryptogenic: second most common mechanism is "unknown"
- Amebic: see Entamoeba histolytica
Management
- Get source control
- Treat for 4-6 weeks, ensuring radiological resolution of abscess
