LIVER ABSCESS

Hafdzi Maulana
 ETIOLOGY
The three major forms of liver abscess, classified by etiology:
• Pyogenic abscess, which is most often polymicrobial, accounts for
80% of hepatic abscess cases in the United States
• Amebic abscess due to Entamoeba histolytica accounts for 10% of
cases
• Fungal abscess, most often due to Candida species, accounts for fewer
than 10% of cases

Akhondi H, Sabih DE. Liver Abscess. [Updated 2020 Jul 6]. In: StatPearls.
Treasure Island (FL): StatPearls Publishing; 2020 Jan
Most Common Etiology
• Amebic Liver Abscess is most often due to E histolytica. Liver
abscess is the most common extraintestinal manifestation of this
infection.
• Fungal abscesses primarily are due to Candida albicans and occur in
individuals with prolonged exposure to antimicrobials, hematologic
malignancies, solid-organ transplants, and congenital and acquired
immunodeficiency. Cases involving Aspergillus species have been
reported.
• Other organisms reported in the literature
include Actinomyces species, Eikenella corrodens, Yersinia
enterocolitica, Salmonella typhi, and Brucella melitensis.
Jun CH, Yoon JH, Wi JW, Park SY, et al. Risk factors and clinical
outcomes for spontaneous rupture of pyogenic liver abscess.
 If chronic hepar abscess not treated
• If untreated, hepatic abscesses can rupture, cause peritonitis and shock. 
• At times the area will get walled off, and chronic pain and discomfort in the
right upper quadrant with occasional nighttime fever can follow.
• 4 – 6 weeks of antibiotic therapy post-drainage can prevent almost any
complications.
• Abscess rupture is a rare complication, occurring in 3.8 percent of
602 patients in one series from Korea. Abscess diameter >6 cm
and coexisting cirrhosis were the main risk factors for rupture,
with most ruptures being perihepatic or into the pleural space.

Akhondi H, Sabih DE. Liver Abscess. [Updated 2020 Jul 6]. In: StatPearls. Treasure Island (FL):
StatPearls Publishing; 2020 Jan
Jun CH, Yoon JH, Wi JW, Park SY, et al. Risk factors and clinical outcomes for spontaneous rupture of
pyogenic liver abscess.
 Antibiotic regimens for pyogenic liver
abscess

Akhondi H, Sabih DE. Liver Abscess. [Updated 2020 Jul 6]. In: StatPearls. Treasure Island (FL):
StatPearls Publishing; 2020 Jan