Pyogenic liver abscess laboratory findings

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

Overview

Laboratory tests consistent with diagnosis of pyogenic liver abscess include complete blood picture, ESR, C-reactive protein, liver function tests, pus culture, and blood culture.^[1]

Diagnostic criteria for pyogenic liver abscess are:^[1]

Liver aspirate or surgical tissue culture positive from a discrete liver abscess
Diagnostic imaging consistent with liver abscess with a concurrent positive blood culture
Diagnostic imaging consistent with liver abscess and a defined radiologic and clinical response to antimicrobial management even if cultures were negative or not performed.

Laboratory tests consistent with diagnosis of pyogenic liver abscess include:^[1]^[2]^[3]

Lab Test	Findings
Complete Blood count	Hemoglobin <10g/dl Leukocytosis Neutrophilia
ESR and CRP	Elevated ESR and C-reactive protein
Liver function tests	Elevated alkaline phosphatase Elevated serum aspartate aminotransferase (AST) Elevated serum alanine aminotransferase (ALT) Elevated bilirubin Decreased albumin and increased globulin
Pus culture	Pus drained from abscess is used for culture and sensitivity
Blood culture	Culture of blood for bacteria

↑ ^1.0 ^1.1 ^1.2 Rahimian J, Wilson T, Oram V, Holzman RS (2004). “Pyogenic liver abscess: recent trends in etiology and mortality”. Clin Infect Dis. 39 (11): 1654–9. doi:10.1086/425616. PMID 15578367.
↑ Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL; et al. (1996). “Pyogenic hepatic abscess. Changing trends over 42 years”. Ann Surg. 223 (5): 600–7, discussion 607-9. PMC 1235191. PMID 8651751.
↑ Rubin RH, Swartz MN, Malt R (1974). “Hepatic abscess: changes in clinical, bacteriologic and therapeutic aspects”. Am J Med. 57 (4): 601–10. PMID 4372883.