Liver abscess: diagnostic and management issues found in the low resource setting

Area of Science:

• Hepatology
• Infectious Diseases
• Global Health

Background:

• Liver abscesses are a significant cause of hospitalization in low-middle income countries (LMICs).
• Pathophysiology varies by etiology (parasitic vs. bacterial), necessitating distinct diagnostic and management approaches.
• Current diagnostic and treatment strategies face limitations in resource-constrained settings.

Purpose of the Study:

• To review the pathophysiology, epidemiology, diagnosis, and management of liver abscesses in LMICs.
• To highlight the challenges and limitations of current approaches in low-resource settings.
• To identify areas for future research and development in liver abscess management.

Main Methods:

• Literature search of PubMed using keywords 'amoebic liver abscess' and 'pyogenic liver abscess'.
• Review of existing data on diagnosis and management strategies in LMICs.

Main Results:

• Amoebic liver abscesses are medically treatable, while pyogenic liver abscesses often require percutaneous drainage and antibiotics.
• Antibiotic misuse in LMICs complicates treatment, posing a therapeutic conundrum.
• Lack of rapid, reliable diagnostics hinders appropriate treatment selection.

Conclusions:

• Effective liver abscess management in LMICs is hampered by diagnostic limitations and antibiotic misuse.
• Future improvements depend on establishing adapted guidelines, promoting antibiotic stewardship, and enhancing diagnostic capabilities.
• Addressing antimicrobial resistance is crucial for advancing liver abscess care in these regions.