Pyogenic liver abscess

Pyogenic liver abscess (PLA) is a type of liver abscess caused by bacterial infection, resulting in pus formation within the liver. It is a serious and potentially life-threatening condition that requires immediate medical attention.

Etiology

The most common bacteria causing PLA are Escherichia coli and Klebsiella pneumoniae. Other bacteria such as Streptococcus, Staphylococcus, and Enterococcus species can also cause PLA. The bacteria can reach the liver through the biliary tract, from a systemic infection, or from an infection in the abdominal cavity.

Clinical Presentation

Patients with PLA often present with fever, right upper quadrant pain, and jaundice. Other symptoms may include nausea, vomiting, weight loss, and malaise. On physical examination, hepatomegaly may be noted.

Diagnosis

Diagnosis of PLA is typically made through imaging studies such as ultrasound or computed tomography (CT) scan, which can reveal the presence of abscesses in the liver. Blood tests may show elevated white blood cell count and liver enzymes. Bacterial culture of the abscess material can help identify the causative organism.

Treatment

Treatment of PLA involves both antibiotic therapy and drainage of the abscess. Antibiotics are used to control the infection, while drainage, either percutaneous or surgical, is performed to remove the abscess. In severe cases, surgical removal of the affected part of the liver may be necessary.

Prognosis

With prompt and appropriate treatment, the prognosis for PLA is generally good. However, if left untreated, PLA can lead to serious complications such as sepsis and liver failure.

See Also

• Liver abscess
• Biliary tract
• Sepsis
• Liver failure