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Liver and intrahepatic bile ducts-nontumor

Infectious (non-viral) disorders

Pyogenic abscess


Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 12 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
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● Uncommon, associated with immunodeficiency
● Usually older patients due to bacteria in biliary tract (30-70%), HIV+ patients with tuberculosis; also other local or systemic infections
● 40% have no known source of infection
● Bacteria detected by aspiration and culture in 85-100% of cases; usually E. coli (35-45%), but often anaerobes or polymicrobial
● Yersinia enterocolitica is associated with iron overload (hemochromatosis)

Treatment
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● Drainage, antibiotics; treat source of infection if known
● Mortality dependant on abscess size (30-90% if large), number of abscesses, severity of underlying illness, patient age

Gross description
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● Single or multiple cavities, usually in right lobe, filled with foul-smelling, creamy yellow, necrotic material
● May have fibrous capsule

Micro description
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● Necrotic material with numerous neutrophils
● Adjacent hepatocytes appear reactive

Additional references
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Cleve Clin J Med 2010;77:426

End of Liver and intrahepatic bile ducts-nontumor > Infectious (non-viral) disorders > Pyogenic abscess


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