Introduction
Liver is an important and vital organ of the body.1 Liver abscess is a suppurative lesion in the liver formed as a result of invasion and multiplication of microorganisms which gain access by entering directly from an injury through the blood vessels or by the biliary ductal system.2 septicemia, direct infection latrogenic, cryptogenic, etc.3
Pyrogenic liver abscess (PLA)
PLA is a pocket of pus that forms in the liver due to bacterial infection (pyrogenic) which have become uncommon due to improved diagnostic facilities and the early use of antibiotics.
This incidence is higher in older age and in immunosuppressed patients such as AIDS, transplant recipients and those on intensive chemotherapy.3
Table 1
Department of pathology (Complete Blood Picture)
Table 2
Department of biochemistry (Serum electrolytes)
|
Test Descripti On |
Results |
Units |
Ref. Range |
Methodo Logy |
|
Sodium |
138 |
mmol/L |
136-145 mmol/L |
ISE direct |
|
Potassium |
4.1 |
mmol/L |
3.5-5.1 mmol/L |
ISE direct |
|
Chlorides |
102 |
mmol/L |
98-107 mmol/L |
ISE direct |
Table 3
Department of biochemistry (Liver profile, Random blood sugar, blood urea, serum creatinine)
Table 4
Department of pathology
|
Test descripti on |
Results |
Units |
Ref. Range |
Methodo logy |
|
Prothrombin time |
25.2 |
seconds |
13.6 seconds |
|
|
APTT |
37.9 |
seconds |
30 seconds |
|
Table 5
Department of microbiology (HBsAG, HIV, HCV)
Morphological feature
Depending upon the cause,
• For pyrogenic liver abscess, they occur as single or multiple yellow abscesses, 1cm or more in diameter in an enlarged liver.3
Amoebic Liver Abscess (ALA)
ALA are less common than pyrogen liver abscess and have similar features. They are caused by the spread of Entamoeba Histolytica from intestinal lesions.
The trophozoite form of amoeba in the colon invade the colonic mucosa forming flask- shaped ulcers from where they are carried to the liver in portal venous system.
Amoeba multiply and block small intrahepatic portal radicles resulting in infarction necrosis of the adjacent liver parenchyma.
History
This case involves P. Kankaiah aged 52 years in Chalmeda Anand rao Institute of Medical Sciences (CAIMS). It had occurred in 2020. He consulted the doctor with symptoms of low-grade fever for 20 days, continuous associated with chills and rigors, pain in abdomen in right hypochondriac and right lumbar, indigestion, constipation.
Discussion
Patient was ordered to test for the following:
Complete blood picture with erythrocyte sedimentation rate
Random blood sugar
Human immunodeficiency virus, hepatitis B surface antigen, hepatitis C virus
Blood Urea
Serum Creatinine
Serum Electrolytes
Liver function tests
Malaria- (Plasmodium falciparum and plasmodium vivax)
Prothrombin time and activated partial thromboplastin time (APTT)
