Liver Diseases: Infections and Types

Study Notes

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)

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

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%

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