Pyogenic Liver Abscess

00:01 Let’s move on to a discussion of pyogenic abscesses.

00:04 Unlike amebic abscesses, these are secondary to another infection.

00:09 Whether it’s bacteremia or an abscess located somewhere else, it has gained access to the systemic circulation with subsequent seeding of the liver.

00:18 Once again, physical findings for both abscesses are usually associated with right upper quadrant abdominal pain.

00:26 Because there’s an ongoing infection, the patient may also report fevers and chills.

00:31 In very severe cases, patients may present with septic shock, low blood pressure, and organ damage.

00:38 Routine chemistries may be normal. You may find an increased WBC or leukocytosis.

00:45 There are variable changes in the liver function test.

00:49 Here’s a CT scan demonstrating a liver abscess in the left lower of the lobe.

00:55 Take a look at the black arrow.

00:59 For amebic abscesses, the treatment is usually metronidazole or commonly known as Flagyl.

01:08 For pyogenic, this usually requires drainage and antibiotics. I remember because pyogenic abscesses may be related to a secondary infection elsewhere. Of course, treatment of the secondary infection is also very important.