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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.