Pyogenic Liver Abscess.

On examination, she was febrile, toxic and was complaining of pain in the shoulder joint. The examination of the shoulder joint was normal. Liver was enlarged 5 cm below the right costal margin and was tender. She did not have intercostal tenderness. The white cell count showed a neutrophil leucocytosis with a total count of 16.8 x 10 9 /L. Ultra sound scan of the abdomen revealed a large abscess in the right lobe of the liver immediately below the right hemidiaphragm. Following a surgical referral, aspiration of the liver abscess was done where 140cc of pus was removed. Her blood culture grew Klebsiella spp. which was sensitive to Cefotaxime and Gentamicin. The aspirated pus, too, grew Klebsiella spp. and another coliform organism. Following the aspiration she was continued on intravenous antibiotics after which she made an uneventful recovery.