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Pyogenic Liver Abscess Due to Fusobacterium Mimicking Metastatic Liver Malignancy

Maroun, Elias N. MD*; Chakrabarti, Amrita MD; Baker, Mary MD; Canchi, Deepti MD; Oehler, Richard L. MD, FACP§; Greene, John N. MD, FACP

Infectious Diseases in Clinical Practice: September 2012 - Volume 20 - Issue 5 - p 359–361
doi: 10.1097/IPC.0b013e318248f3da
Case Reports

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: john.greene@moffitt.org.

The authors have no funding or conflicts of interest to disclose.

© 2012 Lippincott Williams & Wilkins, Inc.