Presentation
Overseas worker with spiking fever and upper abdominal pain.
Patient Data
Large well defined septated abscess in the right lobe of liver, with a relatively small liquified component.
Not amenable to percutaneous drainage.
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.