Introduction: Pyogenic liver abscess accounts for 80% of hepatic abscess cases in the United States. Increasing rates of anaerobic involvement has been reported since 1974. Fusobacterium species are among the most commonly encountered anaerobes, although it is a rare finding to see Fusobacterium species as a cause of liver abscess.
Case Presentation: A 60-year-old man with a history of 100 pack year of tobacco use and chronic obstructive pulmonary disease, presented with radiological findings for metastatic liver malignancy. This was an incidental finding when the patient had a computed tomographic pulmonary angiogram to rule out pulmonary embolism. The incidental findings were followed up with radiological testing, a colonoscopy, endoscopy, and 2 biopsies. The patient’s condition was finally diagnosed as a liver abscess due to Fusobacterium and was successfully treated with a prolonged course of metronidazole.
Conclusion: Pyogenic liver abscess can mimic metastatic malignancy and should be considered when multiple hepatic lesions are seen on an abdominal computed tomography or other compatible diagnostic imaging.
From the *Division of Infectious Diseases and International Medicine, University of South Florida College of Medicine, Tampa, FL; †Moffitt Cancer Center and Research Institute, Tampa, FL; ‡Department of Pediatrics, University of South Florida College of Medicine, Tampa, FL; §Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, University of South Florida College of Medicine; Division of Infectious Diseases, James A. Haley Veterans Medical Center, Tampa, FL; and ∥Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa, FL.
Correspondence to: John N. Greene, MD, FACP, Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, 12902 Magnolia Drive, Mailstop: FOB-3, Tampa, Florida 33612-9497. E-mail: firstname.lastname@example.org.
The authors have no funding or conflicts of interest to disclose.