Liver abscess

Liver abscess
Liver abscess on axial CT image: a hypodense lesion in the liver with peripherally enhancement.
Specialty	Gastroenterology

A liver abscess is a mass filled with pus inside the liver.^[1] Common causes are abdominal conditions such as appendicitis or diverticulitis due to haematogenous spread through the portal vein.^[2] It can also develop as a complication of a liver injury.

Causes

Risk factors for developing liver abscess can be due to

Major bacterial causes of liver abscess include the following:[4]

• Streptococcus species (including Enterococcus)
• Escherichia species
• Staphylococcus species
• Klebsiella species (Higher rates in the Far East)
• Anaerobes (including Bacteroides species)
• Pseudomonas species
• Proteus species
• Entamoeba Histolytica

However, as noted above, many cases are polymicrobial.

Diagnosis

Types

There are several major forms of liver abscess, classified by cause:^[3]

• 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