Author(s): Andee Dzulkarnaen Zakaria*, Syed Hassan, Siti Norzulaikha binti Ramely, Syed Azhar Syed Sulaiman, Amer Hayat Khan
Liver abscess is a pus-filled area in the liver. It is a fairly common disease in Malaysia. The frequent types of liver abscess seen in Malaysia are amoebic and pyogenic abscess. Cultures for pyogenic organisms are often negative. The patient is 38 years old, male admitted to HUSM medical ward with complain of high grade fever for 4 days, on and off shortness of breath, chills, and rigors. Initially, he was treated as community acquired pneumonia. However, after abdominal ultrasound was done, it showed that there was a hypoechoic lesion in sub capsular region of segment IV (refer to Figure 1, 2), measure 4 cm in its largest diameter with irregular margin. Then, patient referred to surgical ward due to his new diagnosis which is liver abscess. The treatment of choice of liver abscess remains controversial. However, the drainage and antibiotic are the management of liver abscess nowadays. There are two types of drainage which are percutaneous and surgical drainage. The decision to do drainage is depend on some aspects which are size of the abscess, location of the abscess, capacity of the lobe, failure of causative treatment, and depth of the abscess. Close monitoring need to be done in long term used of antibiotics. Percutaneous drainage has been published to be safe as first line treatment for liver abscesses and more tolerable than surgical drainage.