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Pyogenic liver abscess


Alternative names

Liver abscess; Bacterial liver abscess

Definition

A pus-filled cavity within the liver.

Causes, incidence, and risk factors

There are many potential causes of liver abscesses. They can be caused by an abdominal infection such as appendicitis , diverticulitis , or a perforated bowel; an infection in the blood; an infection of the biliary (liver secretion) tract; or trauma where a bruised liver becomes infected.

The most common bacteria that cause liver abscesses are Escherichia coli , Klebsiella , Enterococcus , staph and strep, and Bacteroides .

Symptoms

  • Fever , chills
  • Nausea , vomiting
  • Pain in right upper abdomen
  • Loss of appetite
  • Weight loss
  • Weakness
  • Turning yellow ( jaundice )
  • Chalk-colored stool
  • Dark urine

Signs and tests

  • Blood culture that is positive for bacteria; this happens in about half of the patients with pyogenic liver abscess.
  • Occasionally elevated liver enzymes ( liver function tests ) and elevated bilirubin, which causes jaundice.
  • Elevated white blood cell count, indicating infection.
  • Abdominal CT scan
  • Abdominal ultrasound
  • Liver biopsy

Treatment

The treatment usually consists of surgical or percutaneous (through the skin, with a needle) drainage of the abscess . This is accompanied by prolonged antibiotic therapy. Sometimes antibiotics alone can cure the infection.

Expectations (prognosis)

The death rate is 10-30% in treated patients, and it is higher in those with multiple abscesses.

Complications

Life-threatening sepsis can develop.

Calling your health care provider

Call your health care provider if any symptoms of this disorder develop.

Also call if severe abdominal pain , confusion or decreased consciousness , persistent high fever , or other new symptoms develop during or after treatment.

Prevention

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

Update Date: 11/9/2002

Eleftherios Mylonakis, M.D., Division of Infectious Disease, Massachusetts General Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT
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