Liver Abscess

- Pyogenic: MOST COMMON, perc drain and ABX, mostly from cholangitis, diverticulitis, appendicitis, usually GNR (E.coli)
- Amebic: due to Entamoeba histolytic (from Mexico), flagyl and perc drain if toxic
- Echinococcus: positive indirect hemagglutination, preop albendazole, surgical removal with etoh injection to avoid anaphylactic shock
- Schistosomiasis - prizquantel, associated with variceal bleeding, may need surgery to control bleeding
QUESTION: Historically what was the main cause of pyogenic abscesses? what is it now?
ANSWER: Bowel infection (diverticulitis/appendicitis) but now is bilary tract disease (cholangitis)
QUESTION: What is the best way to differentiate between different types of liver abscesses?
ANSWER: CT scan