Pyogenic liver abscess natural history, complications and prognosis

If left untreated, pyogenic liver abscess may progress to peritonitis or pleuritis secondary to rupture of the abscess into peritoneal or pleural cavities and sepsis.^[1][2][3]Complications of pyogenic liver abscess include septicemia, intra-abdominal abscess, hepatic failure, renal failure, recurrent liver abscess and free peritonitis.^[4]The prognosis of liver abscess depends on underlying risk factors such as advanced age, malignancy, jaundice, multiple abscesses, hemoglobin <10g/dl and elevated blood urea nitrogen.^[5]

If left untreated, pyogenic liver abscess may progress to peritonitis or pleuritis secondary to rupture of the abscess into peritoneal or pleural cavities and sepsis leading to death.^[1][2][3]

Complications of pyogenic liver abscess include:^[4]

• Septicemia
• Intra abdominal abscess
• Hepatic failure
• Renal failure
• Recurrent liver abscess
• Massive upper gastrointestinal bleed
• Prolonged biliary drainage
• Free peritonitis

• The prognosis has improved markedly with early diagnosis, drainage and long term antibiotic therapy.^[6]
• If left untreated abscess ruptures leading to death.
• The prognosis of pyogenic liver abscess depends on underlying risk factors such as^[5][7][1]

• Advanced age
• Malignancy
• Shock
• Jaundice
• Multiple abscesses
• Hemoglobin <10 g/dL
• Elevated blood urea nitrogen