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Pyogenic liver abscess

Pyogenic liver abscess is a pus-filled area in the liver. Pyogenic means producing pus.

Causes

There are many possible causes of liver abscesses, including:

  • Abdominal infection, such as appendicitis, diverticulitis, or a perforated bowel
  • Infection in the blood
  • Infection of the bile draining tubes
  • Recent endoscopy of the bile draining tubes
  • Trauma that damages the liver

A number of common bacteria may cause liver abscesses. In most cases, more than one type of bacteria is found.

Symptoms

Symptoms of liver abscess may include:

  • Chest pain (lower right)
  • Pain in the right upper abdomen (more common) or throughout the abdomen (less common)
  • Clay-coloured stools
  • Dark urine
  • Fever, chills, night sweats
  • Loss of appetite
  • Nausea, vomiting
  • Unintentional weight loss
  • Weakness
  • Yellow skin (jaundice)
  • Right shoulder pain (referred pain)

Exams and Tests

Tests may include:

  • Abdominal CT scan
  • Abdominal ultrasound
  • Blood culture for bacteria
  • Complete blood count (CBC)
  • Liver biopsy
  • Liver function tests

Treatment

Treatment usually consists of placing a tube through the skin into the liver to drain the abscess. Less often, surgery is needed. You will also receive antibiotics for about 4 to 6 weeks. Sometimes, antibiotics alone can cure the infection.

Prognosis

This condition can be life threatening. The risk for death is higher in people who have many liver abscesses.

Possible Complications

Life-threatening sepsis can develop. Sepsis is an illness in which the body has a severe inflammatory response to bacteria or other germs.

When to Contact a Medical Professional

Call your health care provider if you have:

  • Any symptoms of this disorder
  • Severe abdominal pain
  • Confusion or decreased consciousness
  • High fever that doesn’t go away
  • Other new symptoms during or after treatment
See also  Acoustic neuroma

Prevention

Prompt treatment of abdominal and other infections may reduce the risk of developing a liver abscess, but most cases are not preventable.

Alternative Names

Liver abscess; Bacterial liver abscess; Hepatic abscess

References

Kim AY, Chung RT. Bacterial, parasitic, and fungal infections of the liver, including liver abscesses. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 84.

Sifri CD, Madoff LC. Infections of the liver and biliary system (liver abscess, cholangitis, cholecystitis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 77.