Hepatic melioidosis

Case contributed by Dr Ian Bickle

Presentation

35 year-old overseas worker with spiking fever and upper abdominal pain.

Patient Data

Age: 35
Gender: Male
Ultrasound

Large well defined septated abscess in the right lobe of liver, with a relatively small liquified component.

Not amenable to percutaneous drainage.

CT

Large septated abscess in segments 6 and 7, with enhancing wall and septae.

The abscess has a honeycomb appearance.

Right basal consolidation and effusion.

Case Discussion

Melioidosis is an infectious disease caused by Burkholderia pseudomallei (previously known as Pseudomonas pseudomallei).

It is a multisystem infection, however has a penchant for the liver and spleen.

Appearances can range from a large 'honeycomb' type abscess to a multitude of microabscesses.

In the liver abscess are largely solid, with those measuring more than 4cm often having a distinct septated appearance like honeycomb.

This is important from a management perspective as virtually all are not amendable to percutaneous drainage.

PlayAdd to Share

Case information

rID: 36526
Case created: 28th Apr 2015
Last edited: 13th Feb 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.