Liver abscess

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Liver abscess
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Fever, abdominal pain, jaundice, nausea, vomiting
Complications	Sepsis, rupture, peritonitis
Onset	Gradual
Duration	Variable
Types	N/A
Causes	Bacterial infection, parasitic infection, fungal infection
Risks	Diabetes mellitus, liver cirrhosis, immunosuppression
Diagnosis	Ultrasound, CT scan, blood culture
Differential diagnosis	Hepatocellular carcinoma, liver cyst, gallbladder disease
Prevention	N/A
Treatment	Antibiotics, percutaneous drainage, surgical drainage
Medication	Metronidazole, ceftriaxone, ampicillin
Prognosis	Generally good with treatment
Frequency	Varies by region
Deaths	N/A

A liver abscess is a pus-filled cavity within the liver that arises due to an infection. It can be caused by several pathogens, including bacterial, parasitic, and fungal organisms.

A depiction of a liver abscess.

Etiology: Causes of Liver Abscess

Bacterial Abscess

The most common cause of liver abscesses is bacterial infection, often arising from the bile ducts or the appendix. The infecting bacteria can enter the liver through the bloodstream or move directly from an infected site nearby.

Parasitic Abscess

Parasitic infections, most notably by Entamoeba histolytica, can lead to amebic liver abscesses. This parasite is typically ingested and can travel to the liver via the bloodstream.

Fungal Abscess

Fungal causes of liver abscesses are less common but can occur, especially in immunocompromised individuals. Candida species are among the most frequent fungal pathogens leading to this condition.

Risk Factors and Pathogenesis

While anyone can develop a liver abscess, some conditions and actions increase the risk:

• Abdominal infections
• Trauma or injury to the liver
• Surgeries in the right upper quadrant of the abdomen
• Gallbladder disease
• Immunosuppressive conditions or medications

Infections often spread to the liver from the bile ducts, intestines, or bloodstream. Once there, they can lead to inflammation and subsequent abscess formation.

Clinical Presentation

Patients with a liver abscess may experience:

• Persistent abdominal pain, predominantly in the right upper quadrant
• Nausea and vomiting
• Fever and chills
• Jaundice (yellowing of the skin and eyes)
• Weight loss and malaise

Diagnosis and Management

Diagnosis often involves imaging studies, such as an ultrasound or CT scan of the abdomen. Blood tests can reveal elevated white blood cell counts, indicative of an ongoing infection. Cultures from the abscess can determine the causative agent, guiding appropriate treatment. Management generally involves a combination of antibiotics and drainage of the abscess. Surgical intervention might be required in certain cases, especially if the abscess is large or fails to respond to initial treatment.

Conclusion

Liver abscesses, although a serious medical condition, are treatable. Early detection and appropriate intervention are crucial for a favorable outcome. It's vital to consult a healthcare professional if one experiences symptoms suggestive of a liver abscess.

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