Pyogenic liver abscess

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

Pyogenic liver abscess

A large pyogenic liver abscess presumed to be the result of appendicitis
Specialty	Gastroenterology

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
Guided aspiration to confirm the diagnosis

Treatment

Antibiotics
Percutaneous drainage under USG or CT control
Laparotomy in intra-abdominal disease

References

Pyogenic hepatic abscesses at eMedicine

External links

Diseases of the digestive system

Lower GI tract
Enteropathy

Small intestine (Duodenum/Jejunum/Ileum)	Enteritis Duodenitis Jejunitis Ileitis Peptic (duodenal) ulcer Curling's ulcer Malabsorption: Coeliac Tropical sprue Blind loop syndrome Small intestinal bacterial overgrowth Whipple's Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption
Large intestine (Appendix/Colon)	Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis/Diverticulosis/SCAD
Large and/or small	Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn's disease Vascular: Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction: Ileus Intussusception Volvulus Fecal impaction Constipation Diarrhea Infectious Intestinal adhesions
Rectum	Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus
Anal canal	Anal fissure/Anal fistula Anal abscess Hemorrhoid Anal dysplasia Pruritus ani

Liver	Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver NASH Vascular Budd–Chiari syndrome Hepatic veno-occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson's disease Hemochromatosis
Gallbladder	Cholecystitis Gallstone / Cholelithiasis Cholesterolosis Adenomyomatosis Postcholecystectomy syndrome Porcelain gallbladder
Bile duct/ Other biliary tree	Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis/Mirizzi's syndrome Biliary fistula Haemobilia Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction
Pancreatic	Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula

Other

Hernia	Diaphragmatic Congenital Hiatus Inguinal Indirect Direct Umbilical Femoral Obturator Spigelian Lumbar Petit's Grynfeltt–Lesshaft Undefined location Incisional Internal hernia Richter's
Peritoneal	Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum

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