Liver Abscess

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Consider when there is right upper quadrant pain, fever and hepatomegaly. Could be a pyogenic liver abscess or amoebic abscess. Surgical or percutaneous drainage should be part of treatment, together with antibiotics. If use of antibiotics without drainage is unavoidable, long course of antibiotics with serial scans and close supervision will be required.

For abscesses threatening to rupture through lobe of liver, skin or diaphragm, aspirate in conjunction with medicine therapy.

Pyogenic Abscess:

	Medicine	Adult Dose	Frequency	Duration
	metronidazole iv	500mg	3 times a day	4-6 weeks
plus	ampicillin iv	1g	4 times a day	4-6 weeks
or	ceftriaxone iv	1g	once a day	4-6 weeks
or	ciprofloxacin po	500mg	twice a day	4-6 weeks

Amoebic Abscess:

Medicine	Dose	Frequency	Duration
Metronidazole po	400mg	3 times a day	7-10 days