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Liver Abscess Treatments

A liver abscess is a pus-filled cavity in the liver. Such a diagnosis used to be fatal 60 to 80 percent of the time, but modern treatments have reduced the mortality rate to 5 to 30 percent. Despite this, it still remains a dangerous infection that will be fatal if left untreated. The incidences of liver abscesses have dropped over the years and now range from eight to 16 cases per 100,000 hospitalized people.

  1. What Happens if Abscess Is Untreated

    • Liver abscesses are usually caused by an intestinal infection where bacteria is carried in the blood from the intestines to the liver. The bacteria that commonly cause liver abscesses are Escherichia coli (E. coli), klebsiella, enterococcus, staph and strep, and bacteroides. An untreated liver abscess will cause sepsis, empyema or peritonitis. With peritonitis, the pleural or peritoneal spaces and retroperitoneal extension will rupture. Any of these complications can cause death.

    Antibiotic Therapy

    • Though antibiotic therapy can aid in treatment of an abscess, it is usually not the sole treatment. It has been used as such with patients who are too ill to undergo invasive therapy or with multiple abscesses that can't easily be drained.

    Antimicrobial Treatment

    • Antimicrobial treatment is used in conjunction with percutaneous or surgical drainage (see next). This treatment may involve 750 mg of metronidazole taken three times a day for 10 days. During the treatment, medication levels, renal function and blood count many be monitored.

    Surgical Drainage/Percutaneous Drainage

    • Though surgical drainage of the abscess is still sometimes done, the standard of care is now percutaneous drainage. Both involve cutting into the body, locating the abscess and draining the pus from it. The drains are maintained until less than 10 cc a day are being withdrawn. Weekly CT or ultrasound scans are also performed to ensure that the abscess is draining sufficiently. Following the drainage of the pus from the liver, patients usually undergo extended antibiotic treatment to ensure all of the pus has been eliminated.

    Medication

    • Paromomycin is a medication that is commonly used to cure intestinal ambebiasis, an intestinal inflammation caused by parasitic ameoba, and it helps the liver heal itself from the effect of the abscess. Other medications include: Metronidazole, Apo-Metronidazole, Femazole, Flagyl, Flagyl ER, Flagystatin, Helidac, Losec Helicopak, Metizol, MetroGel, Metro IV, Metryl, Neo-Tric, Novo-Nidazole, Protostat, Rho-Metrostatin, SK Metronidazole and Trikacide.

    Follow-Up

    • Following initial treatment for the abscess there will be follow-up checks weekly until the doctor is sure the danger has passed. One symptom of a problem is if the patient experiences a persistent fever for two weeks during treatments. This could be an indicator that the body is struggling to fight off the infection and a more aggressive treatment may be required.

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