• Gaetan Khim, Sokhom Em, Satdin Mo, and Nicola Townell.
• Diagnostic Microbiology Development Program, 12152, Phnom-Penh, Cambodia.
• Br. Med. Bull. 2019 Dec 11; 132 (1): 455245-52.

IntroductionLiver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The pathophysiology of abscesses is different depending on the etiology and requires different strategies for diagnosis and management. This paper discusses pathophysiology and epidemiology, the current diagnostic approach and its limitations and management of liver abscess in low resource settings.Sources Of DataWe searched PubMed for relevant reviews by typing the following keywords: 'amoebic liver abscess' and 'pyogenic liver abscess'.Areas Of AgreementAmoebic liver abscess can be treated medically while pyogenic liver abscess usually needs to be percutaneously drained and treated with effective antibiotics.Areas Of ControversyIn an LMIC setting, where misuse of antibiotics is a recognized issue, liver abscesses are a therapeutic conundrum, leaving little choices for treatment for physicians in low capacity settings.Growing PointsAs antimicrobial resistance awareness and antibiotic stewardship programs are put into place, liver abscess management will likely improve in LMICs provided that systematic adapted guidelines are established and practiced.Areas Timely For Developing ResearchThe lack of a quick and reliable diagnostic strategy in the majority of LMIC makes selection of appropriate treatment challenging.© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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