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Posted On : 27 Jan 2019

A TEN YRS OLD GIRL PRESENTED WITH FEVER FOR 1 MONTH AND PAIN RT UPPER ABDOMEN.ON EXAMINATION PT IS NOT TOXIC.FEVER RISE UPTO 100.HER USG SHOWED CAVITY IN LIVER CONTAINING AROUND 450 ML FLUID_?ABCESS_?.CLINICAL IT APPEARED TO BE AMOEBIC LIVER ABCESS.AS PATIENT IS NOT TOXIC.SHE IS DOING ALL HER ROUTINE ACTIVITIES.SHE IS ON Inj CEFTRIXONE ,Inj Metrogyl,Tab Chloroquine.i want to know should i go for usg guided aspiration or wait for a week for medicine response.

Expert Answer :

Answer Discussion :

T

Tumpa Das

0

conservative management and weekly usg follow up of abscess size

6 years ago

A

Alok Kumar

0

can go

6 years ago

N

Nitin Prajapati

0

drainage and culture

6 years ago

A

Asma Yaqub

0

manage conservatively

6 years ago

T

Tojo Thomas

0

conservative management

6 years ago

Answer 1

Well i would suggest the following: Amoebic serology.
Since fever is there for a month now they would definitely be possibility of bacterial infection so anbiotic coverage besides metrogyl is a must. Aspiration is suggested for following:
If there is a thin rim around it so chances of rupture would be there, i mean thin rim from surface or from diaphragm, and for abscess in left lobe.
And it would be useful to confirm bacterial or amoebic too.

Thanks
Neelam mohan
Director
Department of Pediatric Gastroenterology, Hepatology and liver transplant
Medanta Medicity Hospital Gurgaon Delhi NCR
09811043475

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