Hepatic melioidosis - honeycomb liver abscess

Case contributed by Dr Ian Bickle


Right upper quadrant pain and fever

Patient Data

Age: 50 years old
Gender: Male

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.

Case Discussion

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.

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Case information

rID: 21053
Published: 1st Jan 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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