Hepatic melioidosis

Case contributed by Dr Ian Bickle


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

Patient Data

Age: 35
Gender: Male

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.

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Case information

rID: 36526
Published: 29th Apr 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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