Pyogenic liver abscess

Abstract

This chapter studies pyogenic liver abscess. First described by Hippocrates around 400 BC, pyogenic liver abscess is an uncommon hepatic infection, but is associated with significant morbidity and healthcare costs. With the advent of imaging techniques that allow for prompt diagnosis, potent antibiotics, and effective drainage procedures, the mortality from pyogenic liver abscess has declined dramatically over the past several decades. Pyogenic liver abscesses result from seeding of the liver from biliary tract disorders, portal vein pyemia, direct extension, hematogenous spread, or hepatic trauma. Rarely, abscesses develop after arterial embolization or radiofrequency ablation of hepatic tumors. Most patients with pyogenic liver abscesses appear acutely ill with fever and right upper quadrant pain. However, in elderly, debilitated patients, clinical signs may be minimal, potentially delaying diagnosis. The diagnosis of pyogenic liver abscess is made through radiographic imaging and aspiration and culture of abscess material. Meanwhile, the mainstay of treatment of pyogenic liver abscess is systemic antimicrobial therapy in combination with drainage.