Pyogenic liver abscess

A pus-filled cavity within the liver.

Alternative Names

Liver abscess; Bacterial liver abscess

Causes, incidence, and risk factors

There are many potential causes of liver abscesses. They can be caused by an abdominal infection such as appendicitis , diverticulitis , or a perforated bowel; an infection in the blood; an infection of the biliary (liver secretion) tract; or trauma where a bruised liver becomes infected. The most common bacteria that cause liver abscesses are Escherichia coli , Klebsiella , Enterococcus , staph and strep, and Bacteroides .

Signs and tests

  • Blood culture
  • that is positive for bacteria; this happens in about half of the patients with pyogenic liver abscess.
  • Occasionally elevated liver enzymes (
  • liver function tests ) and elevated bilirubin, which causes jaundice.
  • Elevated white blood cell count, indicating infection.
  • Abdominal CT scan
  • Abdominal ultrasound
  • Liver biopsy
  • Treatment

  • The treatment usually consists of surgical or percutaneous (through the skin, with a needle) drainage of the
  • abscess . This is accompanied by prolonged antibiotic therapy. Sometimes antibiotics alone can cure the infection.

    Expectations (prognosis)

    The death rate is 10-30% in treated patients, and it is higher in those with multiple abscesses.

    Complications

    Life-threatening sepsis can develop.

    Calling your health care provider

    Call your health care provider if any symptoms of this disorder develop. Also call if severe abdominal pain , confusion or decreased consciousness , persistent high fever , or other new symptoms develop 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.

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