Pyogenic liver abscess

A pyogenic liver abscess is a type of liver abscess caused by bacteria.

Signs and symptoms

Acute abscess

• Fever
• Lethargy
• Discomfort in Right Upper Quadrant Of Abdomen
• Anorexia
• Enlarged and Tender Liver
• Pleural effusion

Chronic abscess

• Fever
• Abdominal discomfort
• Enlarged liver

Cause

• Biliary disease (most common)

E.g.: stones, cholangiocarcinoma

• Colonic disease

E.g.: diverticulitis, appendicitis, Crohn's disease

• Cryptogenic disease
• Pancreatitis
• Infection of blood
• Intra-abdominal sepsis
• Infection of biliary system
• Traumatic introduction

E.g.: penetrating injury, iatrogenic (radiofrequency ablation)

Common bacterial causes

• Streptococcus milleri
• E. coli
• Streptococcus fecalis
• Klebsiella pneumoniae
• Proteus vulgaris
• Bacteroides
• Opportunistic Pathogens (Staphylococcus)

Diagnosis

• Blood CP (No Leucocytosis)
• Haemoglobin estimation (anaemia)
• Serum albumin levels (Falls rapidly)
• USG and CT Scanning

Treatment

• 1.Antibiotics
  • Penicillins
  • Aminoglycosides
  • Metronidazole
  • Cephalosporins
• 2.Percutaneous Drainage under USG or CT Control
• 3.Laparotomy in intraabdominal disease

References

Pyogenic hepatic abscesses at eMedicine