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Pyogenic liver abscess

Definition

Pyogenic liver abscess is a pus-filled pocket of fluid within the liver. Pyogenic means "with pus".

Alternative Names

Liver abscess; Bacterial liver abscess; Hepatic abscess

Causes

There are many possible causes of liver abscesses, including:

A number of common bacteria may cause liver abscesses. In most cases, more than one type of bacteria are found.

Symptoms

Symptoms of liver abscess may include:

  • Pain in the right upper abdomen (more common) or throughout the abdomen (less common)
  • Clay-colored stools
  • Dark urine
  • Fever, chills, night sweats
  • Loss of appetite
  • Nausea, vomiting
  • Unintentional weight loss
  • Weakness
  • Yellow skin (jaundice)
  • Right shoulder pain (referred pain)
  • Chest pain (lower right)

Exams and Tests

Tests may include:

Treatment

Treatment usually consists of placing a tube through the skin into the liver to drain the abscess. Less often, surgery is needed. You will also receive antibiotics for about 4 to 6 weeks. Sometimes, antibiotics alone can cure the infection.

Outlook (Prognosis)

This condition can be life threatening. The risk for death is higher in people who have many liver abscesses.

Possible Complications

Life-threatening sepsis can develop. Sepsis is an illness in which the body has a severe inflammatory response to bacteria or other germs.

When to Contact a Medical Professional

Contact your health care provider if you have:

Prevention

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

Gallery

Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Amebic brain abscess
Amebiasis, normally an infection of the intestinal tract, may spread and infect other organs such as the liver or brain. Infection of the brain can be fatal. In this slide, ameba are shown in a sample of brain tissue. Ameba represent a serious infection in immunocompromised individuals. (Image courtesy of the Centers for Disease Control and Prevention.)
Digestive system organs
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

References

Kim AY, Chung RT. Bacterial, parasitic, and fungal infections of the liver, including liver abscesses. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 84.

Sifri CD, Madoff LC. Infections of the liver and biliary system (liver abscess, cholangitis, cholecystitis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 75.

Last reviewed September 10, 2022 by Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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