Liver abscess

Risk factors for developing liver abscess can be due to infection, post-procedural infection and metastasis such as primary liver tumours, liver metastasis, biliary procedures, biliary injuries, biliary tract disease, appendicitis, and diverticulitis. Major bacterial causes of liver abscess include the following: • Streptococcus species (including Enterococcus) • Escherichia species • Staphylococcus species • Klebsiella species (Higher rates in the Far East) • Anaerobes (including Bacteroides species) • Pseudomonas species • Proteus species • Entamoeba histolytica However, as noted above, many cases are not polymicrobial. ==Diagnosis==

Types There are several major forms of liver abscess, classified by cause: • Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States. • Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases. The incidence is much higher in developing countries. • Fungal abscess, most often due to Candida species, accounts for less than 10% of cases. • Iatrogenic abscess, caused by medical interventions ==Management==

Draining of the abscess and antibiotics: IV metronidazole and third generation cephalosporin/quinolones, β-lactam antibiotics, and aminoglycosides are effective. == Prognosis ==

The prognosis has improved for liver abscesses. The mortality rate in-hospital is about 2.5-19%. The elderly, ICU admissions, shock, cancer, fungal infections, cirrhosis, chronic kidney disease, acute respiratory failure, severe disease, or disease of biliary origin have a worse prognosis. == References ==