Are steroids an independent risk factor for the development of pyogenic liver abscesses?

Bottom line: Though patients who take steroids are predisposed to infections of all kinds, no large studies have implicated steroid usage as an independent risk factor for pyogenic liver abscesses. Review articles and evidence summaries do not list steroid usage when discussing the etiology of hepatic abscesses. 

Summary of evidence:

Ala, A, HSafar Aly, and AMillar. “Metallic cough and pyogenic liver abscess.” European Journal of Gastroenterology & Hepatology 13.8 (2001):967-969.
In stating, “Hepatic abscesses commonly arise as a result of immunosuppression, notably….steroid therapy,” this case report of a 78-year-old female on long-term steroid treatment who developed a pyogenic liver abscess cites Kandel and Wintch (see next entries).

Kandel G, Marcon NE. Pyogenic liver abscess: new concepts of an old disease. American Journal of Gastroenterology 79.1 (1984): 65-71.
In stating that “patients with certain underlying conditions associated with immunosuppression, notably…steroid therapy…, are predisposed to infections of all kinds, including intrahepatic abscesses,” this review article cites Wintch (see next entry).

Wintch RW, Reines HD, Rambo WM. Liver abscess: a changing entity. The American Surgeon 48.1 (1982): 11-15. 
In a comparison of the clinical course of 25 patients with liver abscesses with a previous series of 22 patients with the same condition, six of the 25 patients with hepatic abscesses had immunologic and hematologic deficiencies. A paragraph that includes “ailments associated with steroid therapy” in a list of “frequently noted diseases,” cites three articles, one of which is a study by Sabbaj of 25 patients with anaerobic pyogenic liver abscesses that listed corticosteroid therapy as a potential cause in one of 11 patients for which the authors found potential sources of the infection.  



About Lisa

I have been a Clinical Informationist (aka Medical Librarian) for Emory University since September 2013. Prior to that, I was a Medical Librarian for Lincoln Memorial University (LMU) from March 2007 to August 2013 and served its DeBusk College of Osteopathic Medicine, Caylor School of Nursing, and allied health programs. From January 2002 - March 2007, I served the Medical Assisting (MA), Occupational Therapy Assistant, Physical Therapy Assistant, Radiologic Technologist, and Nursing programs at South College in Knoxville, Tennessee. I graduated from The University of Tennessee School of Information Sciences with a Master of Science degree in December 2000.
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