What is the microbiology of liver abscess?


The best answer is choice A. Aspiration of an echinococcal cyst carries a risk of anaphylaxis and spread of infection and should only be done if there is serologic and radiographic uncertainty. Imaging typically shows a well-defined cyst with calcifications and budding daughter cysts.

Key Points

  • Risk factors and mechanism of action will suggest the most likely organisms and guide antibiotic choice.
  • Entamoeba histolytica is the most common cause of liver abscess worldwide.
  • Stool PCR and antibody testing for E. histolytica should both be ordered in the work-up of a liver abscess.
  • Calcifications and daughter cysts budding off the main cyst can distinguish echinococcal cyst from E. histolytica abscess radiographically.

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