Health Encyclopedia

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.

Review Date:9/17/2008
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.

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