Pyogenic abscess
Abscesses are not common can be single or multiple
Bacteremia is the most common cause of blood in the portal system as a result of intra-abdominal infections (appendicitis or diverticula Colnah)
But now, in many cases, the reasons unknown
In the elderly, the biliary tract infection is the most common. Other causes include trauma, and bacteremia, and direct spread of cysts on the college.
More organisms are seen Alaicherichiya Cooley ((E.coli and some types of streptococci as well as some anaerobic bacteria such as (bacteroid)
Other organisms are seen intestinal fecal Variables common and Staphylococcus aureus
Infections are often more than a germ (double)
The failure of these bacteria within the plant farms due to prior antibiotic treatment or for failure to provide an anaerobic environment suitable to them.
Clinical symptoms
There are no obvious symptoms in most patients.
Main complaint is fatigue continues for days or even months. The patient can complain of fever, Aruat, anorexia, vomiting, abdominal pain and weight loss
These patients are more prone to bacteremia gram negative septicemia and shock occur
There is not much to uncover in the clinical examination. In some cases, the patient is in the case of poisoning and raise the caloric and jaundice, and in these patients the liver is enlarged and painful and there may be signs of pleural effusion, or friction and Rivta side
Surveys:
That most of the infected and those who do not suffer from a disease but a clear increase caloric idiopathic swab the most natural and often the only reference-oriented diagnosis is the high level of alkaline phosphate in the serum
_ Serum bilirubin may be high at 25% of people
_ Anemia may occur only size only accompanied by a lack of pigment in neutrophils
_ Rise in serum alkaline phosphate (as mentioned earlier)
_ A big increase in the level of vitamin B12 and because of its liberation from the liver (where stores)
_ Blood culture is positive in about 30% of cases
Photography
According to ultrasound in the detection of cysts and may be a CT scanner with a value in the multiple and complex injuries. Radiography was simple (X-Ray) may show up on the right side of the diaphragm and its engrossment Junbaa in severe cases
Depending on the patient's age, the portrayal of the colon may be necessary to know the source of infection
Case management
* Resorption abscess under the guidance of ultrasound
* Give antibiotics and broad-spectrum, which includes Gram-positive and Gram-negative anaerobes, and in order to determine the pathogen
* You must blow up the abscess by needle with a large lumen under the guidance of ultrasound or surgically cured if difficult or long
* Any underlying cause Bjb also be treated
Warning
The case fatality rate depends on the nature of the causative pathogen has been reduced mortality rate to about 16% with a cup of abscesses and antibiotic treatment
The cysts are single cavity, which is located in the right lobe has a better warning of multiple cysts, which have a high risk and high mortality rate of 80%
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Cysts of amoebae
This condition is common occurrence in parts of the world and must be taken into account when people coming from areas endemic
Moves the case of amoebic transformed tissues of the intestine to the liver through the portal venous system. This results in inflammation of the portal vein with multiple abscesses minutes and finally a single abscess or multiple abscesses large
Clinical situation develops slowly and is to be a surprise. Accompanying symptoms include fever, anorexia with weight loss, fatigue
Is often not the story of a previous infection with dysentery
Look at the clinical examination on the patient's signs of tiredness with a painful swelling in the liver and spleen and signs of pleural effusion or alveolar edema (consolidation) at the base of the right chest
Often the patient is not suffering from jaundice
Surveys
In addition to those of pyogenic Bakherajat there serological tests for Baltol dysenteric (hemagglutination, complement fixation test, ELISA)
These tests are always positive status of infection, especially the presence of gastrointestinal symptoms also remains positive after the disappearance of symptoms and therefore they do not describe the current situation
In the event of repeated negative results of these tests, this is strong evidence of the absence of amoebic cysts
Treatment
Metronidazole 800 mg three times daily for ten days
Aspiration of cysts in patients who do not respond to treatment and in the case of large or multiple abscesses and in the case of abscesses in the left lobe of the liver or the risk of rupture is imminent
Complications
Include a rupture, secondary infection, the blood of a criminal offense
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Hepatic injury Mounhqat
And especially the Japanese and dissident mansoni infection turned deadly, while scarce
During the life cycle of the eggs reach the liver through the portal system and fill the branches of the portal vein, causing a Alhabibomat and the occurrence of fibrosis and inflammation, but the occurrence of liver cirrhosis
Clinically speaking splenohepatomegalia and a rise in pressure and portal vein, which is a severe case of injury Mounhqh mansoni
Tests show a rise in the level of alkaline phosphatase may also appear in the faeces and eggs in the biopsies taken from the liver and rectum
Skin tests and immunological tests show the other result is often wrong and may appear positive in the case of previous infection
Treatment using faecal Gwantal fibrosis, but remains with the risk of a rise in pressure in the portal system
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Cysts Alamaria
Caused by Echinococcus granulosus and may be single or multiple. Often occurs at the bottom of the right lower lobe
Surrounding the cysts of three layers: the outer layer and derived from the host laminate and the layer medium and inner germ layer, which contains the heads of the parasite and which will form the bags daughters later
Clinically the patient may not complain of any symptoms and had no pain in the shed right Osama
Surveys
* Laboratory tests show the presence of Hamziat in the peripheral blood in 30% of the cases and positive in the complement fixation test or hemagglutination in 85% of cases
* Simple radiography of the abdomen may show calcification of the outer layer of the cyst.
* Ultrasound and computerized tomography may show cysts in the girls' mother cyst (where the sign is diagnostic task)
Treatment includes
* Given albendazole (10 mg \ kg, which can penetrate the cyst), which can reduce the size of the cyst
*. There is no way depends on the hole injection and aspiration, and then sucking again (puncture, aspiration, injection, reaspiration)
* Cell phone by the needle aspiration under the guidance of ultrasound and the cover of chemotherapy
* Can be removed surgically, while maintaining the cyst intact as possible and after sterilization by alcohol or a saline solution
* Chronic calcified cysts can be left without removing the
* There is no clinical trials court for any of the previous methods
Complications
Include rupture of the cyst and the biliary tract to other organs or to the inside of peritonitis with the spread of infection
Warning
Often good if you do not get complications, although the cyst ruptured and contained in any moment
Methods of prevention include treatment of domestic dog from worms and prevent them from eating the bodies of infected animals and veterinary control programs
Echinococcus granulosus many gaps causing echinococcosis vesicular and is particularly liver disease with high mortality rate if not treated
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