A liver abscess is an infected, pus-filled cavity within the liver. Typically, a liver abscess is caused by a bacterial or parasitic infection. Rarely, in severely immuno-compromised patients, the infection can have a fungal source. Bacterial liver abscesses are often called pyogenic abscesses, while parasitic abscesses are called amebic abscesses. Most commonly, only a single abscess will be present. In the event of multiple abscesses, a vascular route is suspected.
Liver abscesses in themselves are not life threatening. If a liver abscess is left untreated and it bursts, the infection can spread to the blood, causing sepsis, a potentially fatal bacterial blood infection.
Because liver abscesses are caused by infection, anyone can get them. Liver abscesses can be caused by infection in other areas of the body including the gastrointestinal tract, abdomen, the blood, and also as a result of other liver trauma.
Roughly 30-60% of liver abscesses are caused by a biliary tract infection, including biliary obstructive or inflammatory conditions. Infections in the gastrointestinal tract or pelvic region, such as appendicitis or perforated bowel, account for about 24% of all liver abscesses. Hematogenously spread bacteria represent 15% of all liver abscess cases, and about 20% of all cases have no known cause.
Sometimes a liver abscess is completely asymptomatic, while at other times symptoms will be nonspecific such as fatigue. When symptoms are present, they often include:
Seek immediate medical attention if you or someone you know has two or more of the following symptoms:
Blood tests and imaging tests such as ultrasound, CT scan, liver scan, or MRI help detect the presence of a liver abscess.
Treatment depends on the size and location of the abscess or the presence of multiple abscesses. The right lobe of the liver is more commonly affected. Sometimes antibiotics alone can treat the liver abscess.
Other treatments that may be used in the treatment of a liver abscess are:
Avoidance of alcohol; and maintenance of a well-balanced diet; can help prevent the formation of a liver abscess.
Proper hygiene; and avoidance of contaminated food, water, and ice can also help to prevent the formation of a liver abscess.
In the U.S., about 3.6 individuals per 100,000 are afflicted with a liver abscess.
Amebic abscesses are significantly more common in areas with poor healthcare and a high incidence of parasitic infections including: East and South Africa, India, Mexico and parts of Central and South America. These abscesses are about 10 times more likely to occur in men than in women.
Pyogenic liver abscesses affect men and women equally.