What is the Difference Between Amebic and Pyogenic Liver Abscess

The key difference between amebic and pyogenic liver abscess is that amebic liver abscess is caused due to the pathogen Entamoeba histolytica while pyogenic liver abscess is caused due to the pathogens Klebsiella pneumoniae and E. coli.

A liver abscess is a pus-filled mass in the liver that develops from injuries or from intra-abdominal infections caused due to bacteria. Although the liver abscess condition has a low risk, it is essential to detect and manage the lesions since they may develop into a mortality risk later. The usual mechanism of liver abscess is the leakage from the bowel into the abdomen and traveling to the liver through the portal vein. The majority of the liver abscess are categorized as amebic and pyogenic liver abscesses.

CONTENTS

1. Overview and Key Difference
2. What is Amebic Liver Abscess
3. What is Pyogenic Liver Abscess
4. Similarities – Amebic and Pyogenic Liver Abscess
5. Amebic vs Pyogenic Liver Abscess in Tabular Form
6. Summary – Amebic vs Pyogenic Liver Abscess

What is Amebic Liver Abscess?

Amebic liver abscess is a collection of pus in the liver due to a parasite called Entamoeba histolytica. Amebic liver abscess is caused due to an intestinal infection that is known as amebiasis. It is also known as amebic dysentery. After the infection occurs inside the body, the parasite enters the bloodstream from the intestines and then the liver. Amebiasis causes extraintestinal disease, where trophozoites invade the intestinal mucosa and disseminates hematogenously. Trophozoites reach the liver through portal venous circulation. Amebiasis usually spreads from food and water that is contaminated with feces. This is mainly due to the usage of human waste as fertilizers.

Amebiasis spreads from person to person through contact. Thus, amebic liver abscesses are mainly caused due to poor sanitation. Risk factors for amebic liver abscess include alcoholism, cancer, immunosuppression, malnutrition, steroid use, steroid usage, pregnancy, old age, and travel to tropical regions. Patients with amebic liver abscess present right upper quadrant pain in the liver and fever. During the early stages, symptoms are usually subacute. Patients also show diarrhea and minor symptoms of jaundice. The diagnosis of amebic liver abscess is made through a combination of imaging and serologic testing. The majority show solitary lesions, and they are mostly found in the right lobe. Treatment includes a tissue agent and a luminal agent. The tissue agent is usually metronidazole while the luminal agent is used to remove any intraluminal cysts.

What is Pyogenic Liver Abscess?

Pyogenic liver abscess is a condition involving a pus-filled pocket within the liver caused by Klebsiella pneumoniae and E. coli. Pyogenic means producing pus. This condition mostly follows peritonitis due to the leakage of intraabdominal bowel contents through the portal circulation. It also may be a result of arterial hematogenous seeding of systemic infections and poor sanitization. Risk factors include diabetes mellitus, hepatobiliary and pancreatic diseases, liver transplants, and usage of proton-pump inhibitors.

Pyogenic liver abscesses are caused due to abdominal infections such as appendicitis, bacterial infections by Klebsiella pneumoniae and E. coli, blood infections, infections in bile draining tubes, and trauma that damages the liver. Symptoms include chest pain, abdominal pain, clay-colored stools, dark color urine, fever, night sweats, loss of appetite, nausea, vomiting, weight loss, weakness, and jaundice.

Diagnosis of pyogenic liver abscess can be made via CT scan and ultrasound in the abdomen, blood cultures, complete blood count, liver biopsy, and liver function tests. Treatment usually involves placing a tube through the skin into the liver in order to drain the abscess. If essential, surgeries are carried out. During the early stages, it is treated with antibiotics.

What are the Similarities Between Amebic and Pyogenic Liver Abscess?

• Amebic and pyogenic liver abscesses are liver abscess conditions.
• They are caused due to the collection of pus.
• Moreover, both are mainly caused due to poor sanitation.
• Both show jaundice symptoms.
• These conditions can be detected via liver tests and ultrasound scans.

What is the Difference Between Amebic and Pyogenic Liver Abscess?

Amebic liver abscess is caused by the parasite Entamoeba histolytica while pyogenic liver abscess is caused by bacteria Klebsiella pneumoniae and E. coli. Thus, this is the key difference between amebic and pyogenic liver abscess. Besides, amebic liver abscess is common in younger males. Pyogenic liver abscess is seen in older males and females with a history of diabetes. Moreover, amebic liver abscess shows hyperbilirubinemia while pyogenic liver abscess shows hypoalbuminemia.

The below infographic presents the differences between amebic and pyogenic liver abscess in tabular form for side-by-side comparison.

Summary – Amebic vs Pyogenic Liver Abscess

A liver abscess is a pus-filled mass in the liver. Amebic and pyogenic liver abscess are two forms of liver abscess. Amebic liver abscess is caused by Entamoeba histolytica, while pyogenic liver abscess is caused by Klebsiella pneumoniae and E. coli. So, this is the key difference between amebic and pyogenic liver abscess. Both may occur due to poor sanitation and may lead to jaundice conditions.

Reference:

1. “Amebic Liver Abscess.” MedlinePlus, U.S. National Library of Medicine.
2. “Pyogenic Liver Abscess.” Mount Sinai Health System.

Image Courtesy:

1. “Amebiasis Life Cycle” By CDC -(Public Domain) via Commons Wikimedia
2. “Large Hepatic Abscess Mark” By James Heilman, MD – Own work (CC BY-SA 4.0) via Commons Wikimedia