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:

• Bacteroides
• Enterococcus
• Escherichia coli
• Klebsiella pneumoniae
• Staphylococcus aureus
• Streptococcus

In most cases, more than one type of bacteria is found.

• Chest pain (lower right)
• Clay-colored stools
• 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)

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.

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. Many cases are not preventable.

Reddy KR. Bacterial, parasitic, fungal and granulomatous liver diseases. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 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.