Pyogenic Liver Abscess

Pyogenic Liver Abscess

Article
Digestive Health
Diseases & Conditions
+1
Contributed byMaulik P. Purohit MD MPHJan 09, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Bacterial Liver Abscess
  • PLA (Pyogenic Liver Abscess)
  • Pyogenic Hepatic Abscess

What is Pyogenic Liver Abscess? (Definition/Background Information)

  • Pyogenic Liver Abscess (PLA) is an area in the liver that is filled with pus, which is usually caused by a bacterial infection
  • Bile draining tubes, liver damage, and bacterial infections may be responsible for Pyogenic Liver Abscess. The symptoms observed with this condition include pain below the right chest area, dark urine, clay-colored stools, and jaundice
  • A physician may check for liver function and request additional blood and imaging tests to be undertaken, in order to diagnose Pyogenic Liver Abscess
  • Pyogenic Liver Abscess is treated with antibiotics, in case of an infectious cause. Though, draining the pus, and in some cases, surgery, may be also required
  • The condition is not preventable in many cases; however, Pyogenic Liver Abscess can be treated successfully, if abscesses are diagnosed in a timely manner

Who gets Pyogenic Liver Abscess? (Age and Sex Distribution)

  • Pyogenic Liver Abscess can occur in individuals of any age
  • It affects both men and women
  • No predilection is observed for any particular race or ethnic group; the condition is seen worldwide

What are the Risk Factors for Pyogenic Liver Abscess? (Predisposing Factors)

The following are some of the risk factors that could potentially lead to Pyogenic Liver Abscess:

  • Abdominal infections such as diverticulitis, appendicitis, and perforated bowel
  • Blood infection
  • Bile draining tubes infection
  • Liver damage due to trauma
  • Having had a recent endoscopy of bile draining tubes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pyogenic Liver Abscess? (Etiology)

Pyogenic Liver Abscess may be caused by bacterial infections. The chief bacteria responsible for the condition include:

  • Bacteroides
  • Enterococcus
  • Escherichia coli
  • Klebisella pneumonaie
  • Staphyloccus aureus
  • Streptococcus

What are the Signs and Symptoms of Pyogenic Liver Abscess?

Individuals suffering from Pyogenic Liver Abscess may show the following signs and symptoms:

  • Pain in lower right area of the chest
  • Clay-colored stools
  • Dark urine
  • Fever and chills
  • Loss of appetite
  • Nausea and vomiting
  • Pain in the upper right abdomen (which is most common); also, pain throughout the abdomen (which is less common)
  • Unintended weight loss
  • Weakness
  • Jaundice

How is Pyogenic Liver Abscess Diagnosed?

A physician may order the following tests to arrive at an accurate diagnosis of Pyogenic Liver Abscess:

  • Complete physical exam and comprehensive medical history evaluation
  • The tests may include:
    • CBC: Complete blood count
    • Bilirubin blood test
    • Blood culture to find bacteria
    • CT scan of the abdominal area
    • Ultrasound scan of the abdominal area
    • Liver function test
    • Culture of aspirates of liver abscess may be performed in the individual is not getting better with antibiotic treatment. In the laboratory, the culture of the contents of the liver abscess will help determine the types of organism causing the infection and also give information on the type of antibiotics that could be helpful (antibiotic susceptibility information)
    • Biopsy of the liver

What are the possible Complications of Pyogenic Liver Abscess?

The following complications could arise from Pyogenic Liver Abscess:

  • Rupture of Pyogenic Liver Abscess can be life-threatening, which can lead to acute peritonitis
  • PLA can cause the infection to spill into the blood, resulting in various other body parts being infected; a condition termed as sepsis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

How is Pyogenic Liver Abscess Treated?

The following are some treatment methods for Pyogenic Liver Abscess:

  • Draining of the abscess using a tube placed through the skin
  • Surgery: It is not usually required, but may be useful in some cases
  • Antibiotics may be prescribed for anywhere between 4-6 weeks for bacterial infections

How can Pyogenic Liver Abscess be Prevented?

Although Pyogenic Liver Abscess may not be preventable in many cases, the risk of developing a liver abscess can be reduced by quick treatment of abdominal and other infections.

What is the Prognosis of Pyogenic Liver Abscess? (Outcomes/Resolutions)

  • Pyogenic Liver Abscess can be treated successfully, if it is diagnosed early
  • However, it can be a life-threatening condition in individuals older than 70 years of age, if many abscesses are present, and if there are other malignant conditions or immunosuppressive diseases.

Additional and Relevant Useful Information for Pyogenic Liver Abscess:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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