Liver Diseases: Infections and Types

Liver Diseases

Liver Infections

• Liver abscess: a mass filled with pus inside the liver, often caused by abdominal conditions such as appendicitis or diverticulitis.
• Types of liver abscess:
  • Pyogenic liver abscess (80% of cases, often polymicrobial)
  • Amoebic liver abscess (10% of cases, caused by Entamoeba histolytica)
  • Fungal abscess (less than 10% of cases, often caused by Candida species)
  • Iatrogenic abscess (caused by medical interventions)

Hydatid Liver Disease

• Caused by infection with the larval stage of the dog tapeworm Echinococcus granulosus.
• A zoonotic and parasitic infection, acquired from animals through ingestion of tapeworm eggs in infected dog feces.
• Symptoms:
  • Non-specific signs: loss of appetite, weight loss, weakness
  • Vomiting, abdominal pain, shortness of breath
  • Severe allergic reaction and even death if cyst leaks or ruptures
• Diagnosis: Ultrasound, CT, or MRI scans, and blood tests
• Treatment: Albendazole, radical surgical removal

Viral Hepatitis

• Liver inflammation caused by a viral infection.
• Can present in acute or chronic form.
• Most common causes: Hepatitis A, B, C, D, and E.
• Other viruses that can cause liver inflammation: cytomegalovirus, Epstein-Barr virus, yellow fever, and herpes simplex virus.
• Symptoms:
  • Fatigue
  • Flu-like symptoms
  • Abdominal pain
  • Dark urine
  • Pale stool
  • Loss of appetite
  • Unexplained weight loss
  • Jaundice
• Diagnosis: History and physical examination, blood tests, imaging studies, and biopsy
• Treatment:
  • Acute hepatitis: Supportive care
  • Chronic hepatitis: Antiviral drugs (e.g., Ritonavir for Hepatitis C, tenofovir for Hepatitis B)
  • Success rate for sustained viral response for chronic Hepatitis C: 90%

Liver Cirrhosis

• Progressive and widespread death of liver cells associated with inflammation and fibrosis.
• Causes:
  • Alcohol
  • Chronic viral hepatitis (B or C)
  • Immune: Primary sclerosing cholangitis, Autoimmune liver disease
  • Biliary: Primary biliary cirrhosis, Cystic fibrosis
  • Genetic: Hemochromatosis, Wilson's disease
• Clinical features:
  • Hepatomegaly (although liver may also be small)
  • Jaundice
  • Ascites
  • Circulatory changes (e.g., cyanosis)
  • Endocrine changes (e.g., hair loss)
  • Splenomegaly
• Diagnosis: Laboratory tests, imaging tests, and biopsy
• Treatment:
  • Managing causes
  • General diet and lifestyle
  • Decreasing complications
  • Liver transplantation