Therapy of Liver Abscesses

Area of Science:

• Hepatology
• Infectious Diseases
• Microbiology

Background:

• Liver abscess (LA) is a rare but severe condition with high morbidity and mortality.
• Pyogenic liver abscess (PLA) is most common in industrialized regions, while amebic LA occurs more in tropical areas.
• Emerging highly virulent Klebsiella pneumoniae strains are a growing concern, spreading globally.

Purpose of the Study:

• To provide a comprehensive review of liver abscess epidemiology, pathogenesis, diagnosis, and treatment.
• To highlight antimicrobial treatment strategies and the challenges posed by multidrug-resistant pathogens.
• To inform clinical practice regarding the management of liver abscesses.

Main Methods:

• Systematic literature review of epidemiology, pathogenesis, diagnosis, and treatment of liver abscess.
• Focus on antimicrobial therapy, including choices and resistance patterns.
• Analysis of diagnostic imaging and microbiological findings.

Main Results:

• Pyogenic liver abscess (PLA) comprises over 80% of cases; amebic LA accounts for up to 10%.
• Klebsiella pneumoniae is a predominant pathogen in Asia, with increasing global spread.
• Common symptoms include fever, chills, and abdominal pain; diagnosis relies on imaging and microbiology.

Conclusions:

• Diagnosis of LA requires imaging (ultrasound, CT) and microbiological confirmation.
• Optimal PLA treatment involves antibiotics and abscess drainage.
• Amebic LA is effectively treated with metronidazole, often without drainage.