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Pyogenic liver abscess
Definition
Pyogenic liver abscess is a pus-filled area in the liver.
Alternative Names
Liver abscess; Bacterial liver abscess
Causes, incidence, and risk factors
There are many potential causes of liver abscesses, including:
- Abdominal infection such as appendicitis, diverticulitis, or a perforated bowel
- Infection in the blood
- Infection of the liver secretion (biliary) tract
- Recent endoscopy of the biliary system
- Trauma that damages the liver
The most common bacteria that cause liver abscesses are:
- Bacteroides
- Enterococcus
- Escherichia coli
- Klebsiella
- Staphylococcus
- Streptococcus
In most cases, more than one bacteria is found.
Symptoms
- Chalk-colored stool
- Dark urine
- Fever, chills
- Loss of appetite
- Nausea, vomiting
- Pain in right upper abdomen (more common) or throughout the abdomen (less common)
- Unintentional weight loss
- Weakness
- Yellow skin (jaundice)
Signs and tests
Tests may include:
- Abdominal CT scan
- Abdominal ultrasound
- Blood culture for bacteria
- Liver biopsy
- Liver enzymes (liver function tests) and bilirubin
- White blood cell count
Treatment
Treatment usually consists of surgery or going through the skin with a needle or tube (percutaneous) to drain the abscess. Along with this procedure, you will receive long-term antibiotic therapy (usually 4 - 6 weeks). Sometimes antibiotics alone can cure the infection.
Expectations (prognosis)
Even with treatment this condition can be life-threatening in 10-30% of patients. The risk is higher in people who have many abscesses.
Complications
Life-threatening sepsis can develop.
Calling your health care provider
Call your health care provider if you have:
- Any symptoms of this disorder
- Severe abdominal pain
- Confusion or decreased consciousness
- Persistent high fever
- Other new symptoms during or after treatment
Prevention
Prompt treatment of abdominal and other infections may reduce the risk of developing a liver abscess. Many cases are not preventable.
References
Chung RT, Friedman LS. Bacterial, parasitic, and fungal infections of the liver, including liver abscess. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 79.
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Jatin M Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
