Pyogenic liver abscess

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Pyogenic abscessPyogenic abscess
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Liver abscess; Bacterial liver abscess; Hepatic abscess

Definition

Pyogenic liver abscess is a pus-filled pocket of fluid within the liver. Pyogenic means "with 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 tubes draining bile (bile ducts)
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 are found.

Symptoms

Symptoms of liver abscess may include:

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

Exams and Tests

Tests may include:

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.

Outlook (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

Contact 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

Prevention

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

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. 11th ed. Philadelphia, PA: Elsevier; 2021: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. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 75.

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Review Date: 9/10/2022

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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