Liver aspirate must be sent for Gram stain and for bacterial cultures
Abscess draining is the optimal therapy for pyogenic liver abscesses
Up to 50% develop from biliary tract
Remainder are from hepatic artery (bacteraemia), portal vein (abdominal source), contiguous focus (local abscess or cholecystitis) or penetrating trauma
Should include enterobacteriacae, enterococci, anaerobes and in certain situations staph and strep
For duration, review with med micro results
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Required to eliminate intraluminal cysts