Pyogenic liver abscess

Digestive system

Pyogenic abscess

Digestive system organs

Pyogenic liver abscess

Definition:

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.

Symptoms:

Fever, chills
Nausea, vomiting
Pain in right upper abdomen
Loss of appetite
Weight loss
Weakness
Turning yellow (jaundice)
Chalk-colored stool
Dark urine

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.

Review Date: 11/9/2002
Reviewed By: Eleftherios Mylonakis, M.D., Division of Infectious Disease, Massachusetts General Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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