Pyogenic liver abscess physical examination

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

Common physical examination findings associated with pyogenic liver abscess include high grade fever, yellowish discoloration of skin (jaundice), icteric sclera, reduced breath sounds or crepitations at the base of lung, hepatomegaly with point tenderness, and abdominal guarding or rebound tenderness on palpation, dullness on percussion, and absent bowel sounds.^[1]

Common physical examination findings associated with pyogenic liver abscess may include:^[1]

Patients with pyogenic liver abscess appear ill and sweating . Appears thin due to weight loss and confused in later stages of disease.

• High grade fever (>38°C) chills
• Tachycardia

Yellowish discoloration of skin (jaundice)

Icteric sclera

Reduced breath sounds or crepitations at right lung base may be heard

• Chest tenderness on palpation
• Audible pericardial friction rub (sign associated with high mortality)
• S1 and S2 are normal

• Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding.
• Epigastric mass if left lobe is involved
• Abdominal guarding or rebound tenderness
• Due to dullness on percussion, the movement on right side of the chest and abdomen is restricted (ascites)
• Abdominal distension in advanced cases
• Absent bowel sounds

Bilateral pedal edema in advanced liver disease