True about pyogenic liver abscess
A. Single &large abscess
B. X ray features arc diagnostic
C. Serology is confirmatory investigation
D. Systemic complaints, fever &jaundice common
E. Liver enzyme abnormalities are common
Answer (D) Systemic complaints, fever & jaundice
common (E) Liver enzyme abnormalities are common
-the liver abcess is either single or multiple, sized from few milimeter to many centimeters.
-the liver abcess is either single or multiple, sized from few milimeter to many centimeters.
Diagnosis:
-
computed
tomography (CT) scan—to locate the abscess
-
CT with
intravenous contrast—to pinpoint and measure the abscess (very useful when
planning a surgery)
-
blood
tests—elevated white blood count and high neutrophil level indicate infection
-
blood cultures
for bacteria—to identify the bacteria so your doctor knows what antibiotic to
prescribe
-
abdominal
ultrasound—to visualize an abscess in the right upper quadrant
Symptoms:
-
chills, vomiting, fever (most common presenting symptom)
-
right upper abdominal pain
-
sudden dramatic weight loss (> 5 kgs in few weeks)
-
dark-colored urine
-
whitish or clay-colored stool
-
Diarrhea
Laboratory findings
-
Hyperbilirubinemia
is present in only a small proportion of cases.
-
In acute liver
abscess, the aspartate aminotransferase (AST) levels are high.
-
In chronic liver
abscess, the alkaline phosphatase level tends to be elevated and the AST level
tends to be within normal limits. Overall, the alkaline phosphatase level is
elevated in about 70% of cases of amebic liver abscess.
-
Similar CBC count
and liver test abnormalities are found in patients with pyogenic liver
abscesses and are not specific
