A ship worker flown from ship with 12/7 fevers, jaundice, mild RUQ pain, constitutional symptoms.
CT Abdomen + Pelvis
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Large complex multiloculated cystic structure is seen in segments VI and VII of the liver with large periportal lymph nodes. Small right-sided pleural effusion is seen.
DDx Amoebic or bacterial liver abscess.
A percutaneous drain was inserted under CT guidance by local radiology team. Aspirate cultured Klebsiella Pneumonia, consistent with primary bacterial abscess.