Pyogenic liver abscess
Pyogenic liver abscess is a pus-filled area in the liver.
Liver abscess; Bacterial liver abscess
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 bile draining tubes
- Recent endoscopy of the bile draining tubes
- Trauma that damages the liver
The most common bacteria that cause liver abscesses are:
- Escherichia coli
- Klebsiella pneumoniae
- Staphylococcus aureus
In most cases, more than one type of bacteria is found.
- Chest pain (lower right)
- Pain in the right upper abdomen (more common) or throughout the abdomen (less common)
- Clay-colored stools
- Dark urine
- Fever, chills
- Loss of appetite
- Nausea, vomiting
- Unintentional weight loss
- Yellow skin (jaundice)
Exams and Tests
Tests may include:
- Abdominal CT scan
- Abdominal ultrasound
- Bilirubin blood test
- Blood culture for bacteria
- Complete blood count (CBC)
- Liver biopsy
- Liver function tests
Treatment usually consists of placing a tube through the skin to drain the abscess. Less often, surgery is required. You will also receive antibiotics for about 4 - 6 weeks. Sometimes, antibiotics alone can cure the infection.
This condition can be life threatening some patients. The risk for death is higher in people who have many liver abscesses.
Life-threatening sepsis can develop.
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
- Persistent high fever
- Other new symptoms during or after treatment
Prompt treatment of abdominal and other infections may reduce the risk of developing a liver abscess, but most cases are not preventable.
Reddy KR. Bacterial, parasitic, fungal and granulomatous liver diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 360.
Sifri CD, Madoff LC. Infections of the liver and biliary system. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 72.
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.