liver abscess


Hello all this is J. Mounika ,an eighth semester student.This E Log depicts the patient centered approach to learning.

This is an online E Logbook recorded to discuss and comprehend our patient's de-identified health data shared, AFTER taking his/her/guardian's signed informed consent.


A 32 yr old male came with the complaints of fever since 1 week 
HOPI 
Patient was apparently asymptomatic 1 week back and then developed fever which was sudden in onset gradually progressive high grade associated with chills and generalised weakness for which he went to local RMP and took medication for 2 days still the symptoms didnot subside and further investigation like blood test done and his blood sugars were 300mg/dl 
As the symptoms didnot subside they went to Miryalguda hospital there USG was done and impression showed HEPATIC ABSCESS 
and refered to our hospital 
Patient came to hospital yesterday and USG was done impression showing: 
NO H/o vomitings 
No h/o cough cold diarrhoea 

Past history: 
K/c/o DM type 2 since 2 months and was on metformin hydrochloride
Not a k/c/o HTN ,TB, Epilepsy, cerebrovascular accident s

 Personal history: 
Diet mixed 
Appetite normal 
Sleep Adequate
Bowel decreased since 3 days and passed stools yesterday 
Bladder movements are regular 
Addictions: occasional alcohol consumption since 5 years but stopped consumption from 2 months 
Occasionally smoker since 5 years


General examination:-

Patient  is conscious , coherant and co-operative

He is moderately built and nourished

No signs of pallor icterus cyanosis clubbing lymphadenopathy generalized edema

Vitals 

Temperature - 102 F 

BP - 110/70 mm hg 

PR - 86 BPM 

RR - 16 cpm 

Systemic examination

CVS - S1 S2 Heard no murmurs 

RS - BAE + NVBS 

CNS : NFND 

PER ABDOMEN EXAMINATION:
Inspection:

Shape of the abdomen:Distended 

Flanks:Free 

Umbilicus:center,oval shape 

Skin-normal,no sinuses,scars,striae 

No dilated viens 

Abdominal wall moves with respiration 

No hernial orifices 

Palpation:

No local rise of temperature,no tenderness.All inspectory findings are confirmed by palpation. 

Liver:Not palpable,Non tender,no hepatomegaly

Spleen:Not palpable,non tender,no splenomegaly 

Kidney:Non tender and not palpable 

No other palpable swellings 

Percussion: 

On abdomen percussion tympanic note is heard

Liver span:12cms in mid clavicular line 

Spleen:No dullness is heard 

USG DONE on 7/10/23 

Impression: Hepatic abscess of size 9x7cm noted in 5 and 6 segments of liver with 20% liquefaction.

PROVISIONAL DIAGNOSIS:  

HEPATIC ABSCESS 

K/C/O DM TYPE 2 



TREATMENT: 

Inj.NEOMOL 1G IV STAT 

Inj.MAGNEX FORTE 1.5GMS IV STAT 

Inj.METROGYL 500MG IV TID 

Inj.PAN 40MG IV/OD 

IV FLUIDS - NS RL 

Tab.DOLO 650MG PO/SOS 

TEPID SPONGING

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