Skip to Main Content


  • • Etiologies include:

    • -Amebic



    • Risk factors for amebic abscess:

    • -HIV

      -Travel to high prevalence area


    • Hydatid cysts:

    • -Liver (50-70% of cases)

      -Lung (20-30% of cases)




  • • Schistosomal infection major cause of portal hypertension worldwide


Symptoms and Signs


  • • Fever

    • Right upper quadrant pain

    • Jaundice

    • Dyspnea

    • Diarrhea in 33% with amebic abscess

    • Anaphylaxis (hydatid cyst)

    • Palpable hepatic mass (hydatid cyst)

    • For schistosomal disease:

    • -Maculopapular rash









      -Variceal hemorrhage


Laboratory Findings


  • • Leukocytosis

    • Elevated alkaline phosphatase

    • Elevated transaminases

    • Hypoalbuminemia rare for amebic abscess

    Entamoeba histolytica serologic studies (positive in 95% of cases) in amebic abscess

    • Hydatid serologic studies (positive in > 80% of cases)

    • Schistosomal ova in feces

    • Eosinophilia in hydatid disease


Imaging Findings


  • CT scan and US for amebic abscess: Unifocal or multifocal fluid filled areas in liver with peripheral contrast enhancement (not distinguishable from pyogenic)

    CT scan for hydatid cyst: Presence of daughter cysts within parent cyst accompanied by calcification


  • • Pyogenic abscess


  • • History and physical exam

    • CBC

    • Liver function tests

    • Abdomen CT with contrast

    E histolytica serologic studies (positive in 95% of cases) in amebic abscess

    • CT-guided aspiration

    • Hydatid serologic studies (positive in > 80% of cases)

    • Schistosomal ova in feces




  • • CT-guided drainage of hydatid cysts




  • • Metronidazole with or without chloroquine for amebic abscess

    • Albendazole for 8 weeks for hydatid disease

    • Praziquantel for schistosomiasis




  • • Rupture of amebic abscess or hydatid cyst

    • Secondary bacterial infection of amebic abscess or hydatid cyst

    • Hydatid cyst spilling into open peritoneal cavity




  • • Improved sanitation in areas of high risk for E histolytica infection



Chen SC et al: Predictors of mortality in patients with pyogenic liver abscess. Neth J Med 2008;66:183.
Hsieh HF, et al: Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score ≥ 15. Am J Surg 2008;196:346.  [PubMed: 18718219]
Johannsen EC, Sifri CD, Madoff LC: Pyogenic liver abscesses. Infect Dis Clin North Am 2000;14:547.  [PubMed: 10987109]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.