Hepatic abscess

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Fevers and right upper quadrant pain.

Patient Data

Age: 30 years
Gender: Male
ct

Multiple hypodense (30-50HU) lesions in the liver that demonstrate nodular, margins with internal, enhancing septations and measure 30-50HU in density. The lesions are predominantly subcapsular:

  • segment IVa - 34 x 24mm
  • segment VII - 33 x 24mm
  • segment II - 31 x 31mm

A further 6mm hypodensity is noted in liver segment VII, it is unclear whether this is a related lesion or not. Segemental perfusion abnormalities are noted in the right liver on arterial phase and with liver segments II/III on portal venous phases.

Remaining imaged hollow and solid abdominal viscera is unremarkable. BIbasal atelectasis. Right pleural thickening/small pleural fluid collection.

Case Discussion

US guided aspiration of one the lesions was performed and Entamoeba histolytica (a protozoan parasite) was isolated. 

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