Content area
Abstract
Five patients had underlying diverticulitis, most diagnosed only at autopsy.3 Biliary tract or appendix abnormalities are prominent causes of pyogenic liver abscess, but colonic lesions must be considered, including diverticulitis4 and, especially in Asia, colorectal cancer. Because pyogenic liver abscess has such variable pathology1 a microbiological diagnosis should be sought in each case. Anticoagulation can prevent thrombus extension (which may involve the larger mesenteric veins, causing dangerous bowel ischaemia) and embolisation.3 There is no consensus, however, about anaerobic infections causing thrombotic disease.5 The combined use of broad-spectrum antibacterials (empiric until culture results become available), abscess drainage, and appropriate surgery to treat the lesion seeding the liver1,3 will improve survival.