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2014 ; 30
(5
): 334-41
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Therapy of Liver Abscesses
#MMPMID26287275
Lübbert C
; Wiegand J
; Karlas T
Viszeralmedizin
2014[Oct]; 30
(5
): 334-41
PMID26287275
show ga
BACKGROUND: Liver abscess (LA) is an uncommon but potentially life-threatening
disease with significant morbidity and mortality. METHODS: This review
comprehensively describes epidemiology, pathogenesis, diagnosis, and treatment of
LA, with a strong focus on antimicrobial treatment choices and the impact of
multidrug-resistant pathogens. RESULTS: In industrialized areas, pyogenic liver
abscess (PLA) accounts for over 80% of the cases, whereas Entamoeba histolyticais
responsible for up to 10% of the cases, with a higher incidence in tropical
areas. Highly virulent strains of Klebsiella pneumoniaehave emerged as a
predominant cause of PLA in Asian countries and tend to spread to the USA,
Australia, and European countries, therefore requiring special alertness. Most
common symptoms of LA are fever, chills, and right upper quadrant abdominal pain,
although a broad spectrum of non-specific symptoms may also occur. CONCLUSION:
Imaging studies (ultrasound, computed tomography scan) and microbiological
findings play a crucial role in the diagnosis of LA. The treatment of choice for
PLA is a multimodal approach combining broad-spectrum antibiotics and aspiration
or drainage of larger abscess cavities. Amebic LA can be cured by metronidazole
therapy without drainage.