000			02023nam a22002537a 4500
999			_c8217 _d8217
003			MED20080011
005			20240720152620.0
008			160505b2008 xxu||||| |||| 00| 0 eng d
040			_cFEU-NRMF MEDICAL LIBRARY
041			_aEnglish
050			_aMED20080011
100			_aDacanay, Jessamine C., MD. _eauthor
245			_aRuptured pyogenic liver abscess with secondary empyema thoracis / _cJessamine C. Dacanay.
260			_aFairview, Quezon City _bDepartment of Medicine, FEU-NRMF _c2008
300			_c(in folder)
336			_atext _2rdacontent
337			_aunmediated _2rdamedia
338			_avolume _2rdacarrier
504			_aIncludes appendices and bibliographical references.
520			_aABSTRACT: This is a case of E.S., 70 y/o female, who came in with difficulty of breathing. Initial impression was massive pleural effusion. Thoracentesis revealed empyema. Hence ultrasound with mapping was done prior to thoracostomy tube insertion, however there was an incidental finding of liver abscess. Thoracostomy tube was inserted, but only with minimal drainage. VATS was suggested but relatives opted for medical management. Empyema may be diagnosed indirectly by chest x-rays, CT, MRI, or definitively by thoracentesis. Treatment of empyema is drainage of fluid by thoracentesis or CTT with suction. IV antibiotic therapy is administered based on pathogen sensitivity. Pyogenic liver abscess is uncommon, accounting for 8 to 25 cases per 100,000 hospital admissions. Klebsiella pneumoniae is the most common pathogen of pyogenic liver abscesses, among Asians, especially in patients with diabetes mellitus As mortality is high in patients with pyogenic abscess, empirical antibiotic therapy should be broad-spectrum. IV and in high doses. Combinations of agents are required to cover the wide range of possible pathogens, penetrate the abscess cavity, and other bactericidal activity.
521			_aRESDM
887			_aR 003293
942			_2lcc _cRE