What is a liver abscess?
A liver abscess is a pus-filled mass in the liver that can form because of liver damage or an intra-abdominal infection spread by the portal vein.
Liver abscesses are classified into three types based on the underlying cause; bacterial infection, parasite infection, or Injury-induced liver abscess.
1. Pyogenic liver abscess:
This abscess is caused by bacterial infection. "Pyogenic" implies the production of pus. Infections can spread from neighboring structures such as the bile-draining tubes, the appendix, or the intestines. The bloodstream may transport infection from other parts of the body .
2. Amebic liver abscess:
This abscess is caused by the parasite Entamoeba histolytica. Amebic dysentery is caused by E. histolytica, an intestinal infection. The parasite can migrate from the intestines to the liver via circulation. Other organisms or fungi can induce a liver abscess in rare situations .
3. Injury-induced liver abscess:
An abscess can be caused by surgery, a diagnostic procedure, or trauma to the liver .
A liver abscess can rapidly progress into a dangerous infection. A liver abscess, if left untreated, can rupture and disseminate the infection to nearby organs and structures. This can result in significant, potentially fatal consequences and infections.
What are the Symptoms of a Liver Abscess?
Symptoms of a liver abscess may include:
- Pain in the right upper abdomen (more common) or throughout the abdomen (less common)
- Right shoulder pain (referred pain)
- Clay-colored stools
- Yellow skin (jaundice)
- Loss of appetite
- Chest pain (lower right)
- Dark urine
- Fever, chills, night sweats
- Nausea, vomiting
- Unintentional weight loss
What are the Causes of a Liver Abscess?
There are many possible causes of liver abscesses, including:
- Several common bacteria may cause liver abscesses. In most cases, more than one type of bacteria is found.
- Trauma to the liver
- Recent endoscopy of the bile draining tubes
- Abdominal infection, such as appendicitis, diverticulitis, or a perforated bowel
- Infection of the bile draining tubes
- Infection in the blood
Major bacterial causes of a liver abscess include the following;
- Escherichia species
- Pseudomonas species
- Streptococcus species (including Enterococcus)
- Proteus species
- Klebsiella species (Higher rates in the Far East)
- Anaerobes (including Bacteroides species)
- Staphylococcus species
- Entamoeba Histolytica
What is the Treatment for Liver Abscess?
The treatment comprises draining the abscess and administering antibiotics.
- Drainage is required and can be accomplished under the US or CT. For abscesses less than 5 cm in diameter, needle aspiration (at times repeatedly) may be sufficient, but catheter implantation may be necessary if the diameter is greater .
- You will also be given antibiotics for a period of 4 to 6 weeks. IV metronidazole, third-generation cephalosporin/quinolone, -lactam antibiotics, and aminoglycoside are effective treatments. Antibiotics alone can sometimes cure an infection .
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