The document discusses liver abscesses, which can be caused by bacteria (pyogenic) or amoeba. Pyogenic liver abscesses are more common in males and risk factors include diabetes, cancer, and liver transplant. They usually spread to the liver via the blood or directly from other infected sites. Amoebic liver abscesses are caused by Entamoeba histolytica infection through fecal-oral transmission to the liver. Treatment involves antibiotics such as penicillin for pyogenic abscesses or metronidazole for amoebic abscesses. Surgical drainage is sometimes needed for large or complicated abscesses.

2. .

3. pyogenic
trauma amebic
TB candida

4. oM > F 7:1
 Bacterial o40-50 million amoeba
 Most common infections/year worldwide
 M > F 3:1 oAge Extremes
 Risk factor: oEndemic Areas most
• DM susceptible
• Cancer oCountry of origin or
• Liver Transplant Travel
• Pregnancy
• Steroids
• Cancer
• Endemic area travel
(short or long term)

5. o Peritonitis
 To liver via portal circulation
o Direct Spread
o Biliary infections
o Hematogenous Seeding
o Bacteremia
o Sites: R lobe most common
o Blood supply
:
o Fecal-Oral transmission into GI Tract
 To liver via portal circulation
o Can also spread to other extraintestinal sites
o Heart
o Brain
o Lungs

11. ANTIBIOTIC
• Pyogenic: Gram Neg + Anaerobe cov.
• Penisilin
• Combination :
1. ampisilin+aminoglikoside
• +sefalosprin 3th
2. Sefalosporin 3th+klindamisin
3. Metronidazol
48-72 jam  perbaikan -  kultur
• Perenteral 10-14 hari, 6 minggu oral
• Amoeba: Metronidazol, tinidazol
• 50 mg/kgBB  10 hari

12. early
• Treated with drug and no clinical improvement occurs in 48 to 72 hour
• All large abscesses (especially those presenting as localised swellings or
bulges of right lower thorax)
• Superficial abscess
• Abscesses causing severe pain or having marked tenderness or edema
and abscess with mark elevation of the diafragma
immediate
• Impending perforation
• Cases with left lobe abscess
• Ruptuire into the pericardiac sac or peritoneal cavity