|Liver abscess on axial CT image: a hypodense lesion in the liver with peripherally enhancement.|
A liver abscess is a mass filled with pus inside the liver. Common causes are abdominal conditions such as appendicitis or diverticulitis due to haematogenous spread through the portal vein. It can also develop as a complication of a liver injury.
Risk factors for developing liver abscess can be due to infection, post-procedural infection and metastasis such as primary liver tumours, liver metastasis, biliary procedures, biliary injuries, biliary tract disease, appendicitis, and diverticulitis.
Major bacterial causes of liver abscess include the following:
However, as noted above, many cases are polymicrobial.
There are several major forms of liver abscess, classified by cause:
Antibiotics: IV metronidazole and third generation cephalosporin/quinolones, β-lactam antibiotics, and aminoglycosides are effective.
The prognosis has improved for liver abscesses. The mortality rate in-hospital is about 2.5-19%. The elderly, ICU admissions, shock, cancer, fungal infections, cirrhosis, chronic kidney disease, acute respiratory failure, severe disease, or disease of biliary origin have a worse prognosis.