Pyogenic liver abscesses

Abstract

Pyogenic-liver abscess is a relatively rare entity in Europe. Due to unspecific clinical and biological findings, the diagnosis can be difficult. Imaging by ultrasound, CT-scan or MRI is important to confirm the diagnosis and to determine further investigations and treatment. According to the characteristics of the abscess, a surgical intervention may be necessary, particularly is the abscess diameter is bigger than 5 cm. This can be done either by surgery or by percutaneous drainage (needle aspiration versus catheter drainage). Obtaining adequate microbiologic cultures is important to identify the responsible pathogens and their resistance profile before starting broad spectrum antibiotics. Antibiotic treatment should be adapted to microbiologic results. The recommended treatment duration is usually between 4 and 6 weeks according to clinical evolution.