[Liver abscess]

Abstract

Liver abscesses are bacterial or parasitic. In a patient presenting with fever, fatigue and upper right abdominal pain, abdominal ultrasound must be performed to reveal a liver mass. Clinical history and serologies allow presumptive diagnosis. Pyogenic abscesses are mostly secondary to biliary tree infection. Pus aspiration and culture confirm the diagnosis. Gram-negative bacilli and anaerobes are the most frequent germs. Percutaneous drainage combined with antibiotics is the standard treatment. Earlier diagnosis, better techniques for bacterial culture and adapted treatment have improved prognosis. Amoebic abscesses are less frequent but their incidence is increasing in the presence of immunosuppressed state. The diagnosis is based on abdominal ultrasound and serology. Treatment is principally medical.