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摘自 First choice
Kp : DM
Amebic (E. histolytica) : 旅遊衛生環境差, AIDS, 較少黃疸細菌性較多黃疸
Incubation times are typically 1 - 3 weeks for colitis
and 2 weeks to several months for liver abscesses.
Most infected people are asymptomatic
For liver abscess, severe intestinal disease, or extraintestinal disease,
treat with metronidazole or tinidazole followed by iodoquinol or paromomycin.
Hydatid cyst : 肝包囊蟲
frequent peripheral focal areas of calcification
Septation and daughter cysts
water-lily sign
Common polymicrobial : Mixed enteric facultative and anaerobic species
Enteric GNB : E. coli, K. pneumonia, Bacteroides
Gram-positive : Streptococci, Enterococci
Well-known risk factor for K. pneumoniae liver abscess : Diabetes mellitus
Liver abscess Empirical : Claforan 2g Q8H + Metronidazol 500mg Q8H
Drainage : Percutaneous or surgical
Antibiotics :
- 3rd generation cefa + Metronidazole
- Piperacillin-tazobactam
- Carbapenem
Consider the possibility of occult colorectal neoplasia in patients
diagnosed with pyogenic liver abscess
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