A pyogenic liver abscess is a collection of pus in the liver that forms when a bacterial infection reaches the organ.

Without early diagnosis and treatment, a pyogenic liver abscess may lead to severe complications and can be life threatening. Antibiotics and abscess drainage are effective treatments for pyogenic liver abscesses and can help prevent complications.

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A pyogenic liver abscess is an area in the liver that is full of pus, a thick fluid the body creates in response to infection.

“Pyogenic” means to produce pus. An abscess is an enclosed area of pus within the body.

Liver abscesses usuallyTrusted Source form due to a leak in the bowels that reaches the liver via the portal vein, which transports blood from abdominal organs to the liver.

An infection in the biliary tract may also directly reach the liver and cause an abscess. The biliary tract includes the gallbladder and bile ducts, which help produce and store bile.

If an infection is unable to properly drain away from the liver, pus can form a mass within the organ.

A range of different bacteria or parasites can cause pyogenic liver abscesses. Common bacteria related to pyogenic liver abscesses include:

  • E. coli
  • anaerobes
  • Staphylococcus
  • Streptococcus
  • Klebsiella
  • Entamoeba histolytica, which causes amoebic liver abscesses

A pyogenic liver abscess may form due to condition affecting the biliary tract, such as:

Learn more about liver abscesses.

Symptoms of pyogenic liver abscess are nonspecific and overlap with many other conditions. Symptoms of a liver abscess may include:

People must contact a doctor immediately if they have any symptoms of a pyogenic liver abscess. Without prompt diagnosis and treatment, a pyogenic liver abscess can lead to life threatening complications.

A doctor may first take a medical history, assess symptoms, and perform a physical examination. A doctor may askTrusted Source questions about occupation, travel, and any recent infections or medical treatments to assess the risk of pyogenic liver abscess.

To diagnose pyogenic liver abscess, doctors may carry out the following tests:

  • complete blood count
  • blood culture test, which checks for bacteria
  • other blood tests to check for certain enzymes and proteins that can indicate inflammation
  • liver function tests
  • ultrasound of the abdomen
  • needle biopsy to identify the exact cause of the liver abscess
  • CT scan

Pyogenic liver abscesses usuallyTrusted Source occur as a complication of a biliary tract condition, such as:

  • gallstones
  • biliary stricture, a narrowing of the bile ducts
  • bile duct cancer
  • congenital anomalies (sometimes called birth defects) affecting the biliary tract

Other causes of pyogenic liver abscess include abdominal infections, such as acute appendicitis, and trauma to the abdomen.

Risk factors

Research suggests diabetes increasesTrusted Source the risk of pyogenic liver abscess. Other conditions that are risk factors include:

Other risk factors for liver abscess includeTrusted Source:

The main first-line treatments for a pyogenic liver abscess include percutaneous abscess drainage and antibiotics.

With percutaneous abscess drainage, a doctor inserts a needle or catheter through the skin of the abdomen to drain fluid from the pyogenic liver abscess. Doctors will use imaging, such as ultrasound, to guide the procedure.

If the specific cause of infection is unknown, people will requireTrusted Source treatment with antibiotics, which target a wide range of bacteria. Antibiotic treatment may include:

  • cephalosporins and metronidazole
  • beta-lactam/beta-lactamase inhibitor and metronidazole
  • synthetic penicillin with aminoglycosides and metronidazole

In most cases, people will first receive intravenous antibiotics followed by a course of oral antibiotics. They will generally require antibiotic treatment for 2 to 6 weeks.

Without treatment, a pyogenic liver abscess can leadTrusted Source to life threatening complications. If a liver abscess ruptures, it may cause shock and peritonitis, which involves inflammation of the abdominal lining.

Abscess drainage may also lead to severe complications, such as:

Adhering to an antibiotic regimen for 4 to 6 weeks can prevent most complications after abscess drainage. Follow-up after treatment is also vital to help prevent, identify, and treat complications early.

A pyogenic liver abscess is a collection of pus that forms in the liver. This kind of abscess can form if a bacterial infection reaches the liver, which can occur due to a biliary tract condition, liver injury, or abdominal infection.

Pyogenic liver abscesses can be life threatening without treatment, so early diagnosis and management are essential. Antibiotics and abscess drainage can treat pyogenic liver abscesses and help prevent complications.

People who have any symptoms of a pyogenic liver abscess or experience concerning symptoms following treatment for a liver abscess should contact a doctor immediately.