Pyogenic liver abscess pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Pathophysiology

• Development of pyogenic liver abscess is the result of extension of infection through the following:

• Portal vein
• Hepatic arteries as metastatic abscessess
• Direct spread from nearby infection
• Trauma
• Retroperitoneal extension from appendix (suppurative appendicitis most frequent source of infection)

• Ascending biliary infection is the most common source of pyogenic liver abscess
• Bacteria involved in pyogenic liver abscess include:

Pyogenic liver abscess

Bacteria

Gram-positive aerobes

Gram-negative enterics

Anaerobic organisms

Acid fast bacilli

Streptococcus sp Staphylococcus aureus / Staphylococcus epidermidis Actinomyces sp Enterococcus sp Streptococcus milleri

Escherichia coli Salmonella typhi Yersinia enterocolitica K.pneumonia Pseudomonas sp Proteus sp Eikenella corrodens Others

Bacteroids sp Fusobacterium Anaerobic/ Microaerophilic streptococci Other anaerobes

Mycobacterium tuberculosis