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Gastrointestinal
Diagnosis
Liver
Infection
Hepatic Pyogenic Abscess
Hepatic Pyogenic Abscess
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Localized collection of pus in liver due to bacterial infection with destruction of hepatic parenchyma

              IMAGING

              • General Features

                • Radiographic Findings

                  • Fluoroscopic Findings

                    • CT Findings

                      • MR Findings

                        • Ultrasonographic Findings

                          • Nuclear Medicine Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Gross Pathologic & Surgical Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Kumar SK et al: Pyogenic liver abscess: clinical features and microbiological profiles in tertiary care center. J Family Med Prim Care. 9(8):4337-42, 2020
                                                2. Wang N et al: Differentiation of liver abscess from liver metastasis using dual-energy spectral CT quantitative parameters. Eur J Radiol. 113:204-8, 2019
                                                3. Giambelluca D et al: The "double target sign" in liver abscess. Abdom Radiol (NY). 43(10):2885-6, 2018
                                                4. Serraino C et al: Characteristics and management of pyogenic liver abscess: a European experience. Medicine (Baltimore). 97(19):e0628, 2018
                                                5. Kuo SH et al: Mortality in emergency department sepsis score as a prognostic indicator in patients with pyogenic liver abscess. Am J Emerg Med. 31(6):916-21, 2013
                                                6. Alsaif HS et al: CT appearance of pyogenic liver abscesses caused by Klebsiella pneumoniae. Radiology. 260(1):129-38, 2011
                                                7. Benedetti NJ et al: Imaging of hepatic infections. Ultrasound Q. 24(4):267-78, 2008
                                                8. Park SY et al: Radiofrequency ablation of hepatic metastases after curative resection of extrahepatic cholangiocarcinoma. AJR Am J Roentgenol. 198(1):2, 2012
                                                9. Aydin C et al: Fistulisation of pyogenic liver abscess into the portal vein and bile ducts. Singapore Med J. 52(7):e153-5, 2011
                                                10. Ho MP et al: Pyogenic liver abscess in older adults: comparison with younger individuals. J Am Geriatr Soc. 59(6):1160, 2011
                                                11. Muthukumarasamy G et al: Intrahepatic abscess secondary to acute calculous cholecystitis. Br J Hosp Med (Lond). 72(5):291, 2011
                                                12. Onder A et al: Surgical management of pyogenic liver abscess. Eur Rev Med Pharmacol Sci. 15(10):1182-6, 2011
                                                13. Pang TC et al: Pyogenic liver abscess: an audit of 10 years' experience. World J Gastroenterol. 17(12):1622-30, 2011
                                                14. Tu JF et al: Comparison of laparoscopic and open surgery for pyogenic liver abscess with biliary pathology. World J Gastroenterol. 17(38):4339-43, 2011
                                                15. Lederman ER et al: Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol. 100(2):322-31, 2005
                                                16. Kurland JE et al: Pyogenic and amebic liver abscesses. Curr Gastroenterol Rep. 6(4):273-9, 2004
                                                17. Johannsen EC et al: Pyogenic liver abscesses. Infect Dis Clin North Am. 14(3):547-63, vii, 2000
                                                18. Giorgio A et al: Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology. 195(1):122-4, 1995
                                                19. Méndez RJ et al: Hepatic abscesses: MR imaging findings. Radiology. 190(2):431-6, 1994
                                                20. Jeffrey RB Jr et al: CT of small pyogenic hepatic abscesses: the cluster sign. AJR Am J Roentgenol. 151(3):487-9, 1988
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Definitions

                                                              • Localized collection of pus in liver due to bacterial infection with destruction of hepatic parenchyma

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • Fluoroscopic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Nuclear Medicine Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Gross Pathologic & Surgical Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Kumar SK et al: Pyogenic liver abscess: clinical features and microbiological profiles in tertiary care center. J Family Med Prim Care. 9(8):4337-42, 2020
                                                                                              2. Wang N et al: Differentiation of liver abscess from liver metastasis using dual-energy spectral CT quantitative parameters. Eur J Radiol. 113:204-8, 2019
                                                                                              3. Giambelluca D et al: The "double target sign" in liver abscess. Abdom Radiol (NY). 43(10):2885-6, 2018
                                                                                              4. Serraino C et al: Characteristics and management of pyogenic liver abscess: a European experience. Medicine (Baltimore). 97(19):e0628, 2018
                                                                                              5. Kuo SH et al: Mortality in emergency department sepsis score as a prognostic indicator in patients with pyogenic liver abscess. Am J Emerg Med. 31(6):916-21, 2013
                                                                                              6. Alsaif HS et al: CT appearance of pyogenic liver abscesses caused by Klebsiella pneumoniae. Radiology. 260(1):129-38, 2011
                                                                                              7. Benedetti NJ et al: Imaging of hepatic infections. Ultrasound Q. 24(4):267-78, 2008
                                                                                              8. Park SY et al: Radiofrequency ablation of hepatic metastases after curative resection of extrahepatic cholangiocarcinoma. AJR Am J Roentgenol. 198(1):2, 2012
                                                                                              9. Aydin C et al: Fistulisation of pyogenic liver abscess into the portal vein and bile ducts. Singapore Med J. 52(7):e153-5, 2011
                                                                                              10. Ho MP et al: Pyogenic liver abscess in older adults: comparison with younger individuals. J Am Geriatr Soc. 59(6):1160, 2011
                                                                                              11. Muthukumarasamy G et al: Intrahepatic abscess secondary to acute calculous cholecystitis. Br J Hosp Med (Lond). 72(5):291, 2011
                                                                                              12. Onder A et al: Surgical management of pyogenic liver abscess. Eur Rev Med Pharmacol Sci. 15(10):1182-6, 2011
                                                                                              13. Pang TC et al: Pyogenic liver abscess: an audit of 10 years' experience. World J Gastroenterol. 17(12):1622-30, 2011
                                                                                              14. Tu JF et al: Comparison of laparoscopic and open surgery for pyogenic liver abscess with biliary pathology. World J Gastroenterol. 17(38):4339-43, 2011
                                                                                              15. Lederman ER et al: Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol. 100(2):322-31, 2005
                                                                                              16. Kurland JE et al: Pyogenic and amebic liver abscesses. Curr Gastroenterol Rep. 6(4):273-9, 2004
                                                                                              17. Johannsen EC et al: Pyogenic liver abscesses. Infect Dis Clin North Am. 14(3):547-63, vii, 2000
                                                                                              18. Giorgio A et al: Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology. 195(1):122-4, 1995
                                                                                              19. Méndez RJ et al: Hepatic abscesses: MR imaging findings. Radiology. 190(2):431-6, 1994
                                                                                              20. Jeffrey RB Jr et al: CT of small pyogenic hepatic abscesses: the cluster sign. AJR Am J Roentgenol. 151(3):487-9, 1988