Pyogenic liver abscess
Pyogenic liver abscess is a pus-filled area in the liver. Pyogenic means producing pus.
Liver abscess; Bacterial liver abscess; Hepatic abscess
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 of liver abscess may include:
- 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, nightsweats
- Loss of appetite
- Nausea, vomiting
- Unintentional weight loss
- 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 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.
This condition can be life threatening. The risk for death is higher in people who have many liver abscesses.
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
Prompt treatment of abdominal and other infections may reduce the risk of developing a liver abscess, but most cases are not preventable.
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.
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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.