Hepatic melioidosis - honeycomb liver abscess
Right upper quadrant pain and fever
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Large multiseptated 'honeycomb' abscess in the caudate lobe. Multiple tiny microabscesses in the spleen.Small collection or necrotic node inferior to the liver adjacent to pancreatic head.
Melioidosis is due to the Gram-negative bacterium, Burkholderia pseudomallei. lt ia a saprophyte found in wet soils and is endemic to Southeast Asia and parts of Australia. In rural areas muddy standing water in drains and ditches are commonplace. It occurs most commonly in those who are immunosuppressed in some form, particularly in those with diabetes mellitus.
Although a wide range of organ systems can be involved the lungs, liver and spleen are the most common sites. It is common to observe involvement of various organs at the same time. A “honeycomb” appearance has been described as characteristic for large melioidosis hepatic abscesses.
The large lesions are typically multi-loculated and multi-septated, giving rise to the “honeycomb” appearance. This has been reported to be characteristic for melioidosis liver abscesses that are larger than 2 cm.
- 1. Lim KS, Chong VH. Radiological manifestations of melioidosis. Clin Radiol. 2010;65 (1): 66-72. doi:10.1016/j.crad.2009.08.008 - Pubmed citation
- 2. Lim KS, Chong VH. Radiological manifestations of melioidosis. Clin Radiol. 2010;65 (1): 66-72. doi:10.1016/j.crad.2009.08.008 - Pubmed citation
- 3. Chamadol N, Laopaiboon V, Techasatian P et-al. Computerized tomographic findings of hepatic fascioliasis compared with melioidosis-caused liver abscesses. J Med Assoc Thai. 2010;93 (7): 838-48. Pubmed citation