A liver abscess is a mass filled with pus inside the liver.
Causes
Risk factors for developing liver abscess can be due to
infection, post-procedural infection and
metastasis such as primary
Liver tumor,
liver metastasis, biliary procedures, biliary injuries, biliary tract disease,
appendicitis, and
diverticulitis.
Major bacterial causes of liver abscess include the following:
However, as noted above, many cases are polymicrobial.
Diagnosis
Types
There are several major forms of liver abscess, classified by cause:
-
Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States.
-
Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases. The incidence is much higher in developing countries.
-
Fungal abscess, most often due to Candida species, accounts for less than 10% of cases.
-
Iatrogenic abscess, caused by medical interventions
Management
Draining of the abscess and antibiotics: IV
metronidazole and third generation
cephalosporin/quinolones, β-lactam antibiotics, and
are effective.
Prognosis
The prognosis has improved for liver abscesses. The
mortality rate in-hospital is about 2.5-19%. The
Old age, ICU admissions, shock,
cancer,
Fungal infection,
cirrhosis, chronic kidney disease, acute respiratory failure, severe disease, or disease of biliary origin have a worse
prognosis.
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