LIVER DISEASES PART ONE
Liver abscess occurs when bacteria or protozoa destroy liver tissue, producing a cavity that fills with infectious organisms, liquefied liver cells and white blood cells. The dead tissues may then seal off the cavity from the rest of the liver making it less effective. Although uncommon, sometimes the puss-filled abscesses may rapture into another body cavity resulting into multiple abscesses, posing serious complications for the patient and can sometimes be fatal.
The puss-filled liver abscesses commonly result from infection by such bacteria as Escherichia coli (E.coli), Klebsiella, Entrobacter, Salmonella, Staphylococcus and Enterococcus. These bacteria may invade the liver through liver wound, or spread from the lungs, skin, or other organs through the liver’s artery, veins or bile duct. And usually more than one abscess is present often allowing peritonitis, cholecystitis, pneumonia and bacterial endocarditis.
An amoebic abscess is usually caused by the infection of protozoa- Entamoeba histolytica..the same organism that is mostly associated with dysentery. And usually there is one amoebic abscess occurring in the right lobe of the liver.
The symptoms vary from one individual to another. In some people, they are acutely ill while in others, the abscess is recognized only during autopsy after death from another illness. The bacterial symptoms are sudden and those of protozoan origin are more subtle. And the common signs may include; right abdominal and shoulder pains, weight loss, fever, chills, perspiration, nausea, vomiting and anemia. If the abscess extends to the diaphragm, there will be signs in the lungs. Abscess related liver damage may also cause jaundice.
Usually the doctor reviews the patients’ medical history and among other tests evaluates a liver scan to check for filling defects at the area of abscess. A liver ultrasound may also indicate the presence of an abscess but is less definitive than a liver scan. Computed tomography scan (CAT scan) can be used to confirm the diagnosis. Also laboratory tests such as blood/stool cultures are used to provide additional details as the protozoa or bacteria responsible can be easily identified.
The physician can start antibiotic therapy immediately if the causal organism has not been isolated. And if cultures show that the infection is caused by E.coli, the treatment includes drugs like ampicillin-(good for gram negative rods such as E.coli)
If the tests show the presence of Entamoeba histolytica, then the treatment will include Aralen or Flagyl. The therapy usually continues for 2 to 4 months. And an abscess that fails to respond can be surgically removed.