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NewYork-Presbyterian Hospital Psychiatry
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Case of the Month - February 2018

This 34 year old male presented to the ED with fever x 10 days, weakness, rigors, dyspnea on exertion and upper abdominal pain.

Question 1 : What’s wrong with these pictures?

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Answer 1:

There is a large lesion in the liver most consistent with an abscess (arrows below.)

Question 2: What are some causes of liver abscesses?
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Answer 2:

Most liver abscesses are pyogenic (due to bacteria, usually polymicrobial), amebic abscesses due to Entamoeba histolytica or fungal (usually due to Candida.) Biliary tract disease is a common cause of pyogenic liver abscesses. Abscesses can also occur due to systemic bacteremia. This patient underwent IR drainage of the abscess and was treated with IV antibiotics. After testing, the cause was thought to be Entamoeba and he was changed to paromomycin.

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