Pyogenic and Amebic Infections of the Liver

Gastroenterol Clin North Am. 2020 Jun;49(2):361-377. doi: 10.1016/j.gtc.2020.01.013.


Pyogenic liver abscesses are classified by the bacteria that have caused the abscess because this guides treatment and can point to the underlying cause. The most common cause is biliary disease. The diagnosis is made by imaging. Treatment is a combination of antibiotics and percutaneous drainage. Amebic liver abscess is caused by extraintestinal spread of Entamoeba histolytica. E histolytica is spread by fecal-oral transmission and typically colonizes the gastrointestinal tract. It is diagnosed based on imaging and the mainstay of treatment is metronidazole. Only about 15% of cases require percutaneous drainage. The prognosis is good, with almost universal recovery.

Keywords: Amebic liver; Liver abscess; Pyogenic liver.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Drainage / methods
  • Entamoeba histolytica*
  • Humans
  • Liver Abscess, Amebic* / diagnosis
  • Liver Abscess, Amebic* / epidemiology
  • Liver Abscess, Amebic* / parasitology
  • Liver Abscess, Amebic* / therapy
  • Liver Abscess, Pyogenic* / diagnosis
  • Liver Abscess, Pyogenic* / epidemiology
  • Liver Abscess, Pyogenic* / etiology
  • Liver Abscess, Pyogenic* / therapy
  • Metronidazole / therapeutic use*
  • Tomography, X-Ray Computed
  • Ultrasonography


  • Anti-Bacterial Agents
  • Metronidazole