PMC4711182_01
(a) Abdominal CT scan with intravenous contrast showing a sizable (cyst containing) hypodense lesion with thickened wall (15 mm) in the right liver lobe (liver section 5 and 6), peripherally to the liver's capsule (red arrow). Lesions maximum dimensions were 10 x 10 x 8 cm. It displayed also minimum fluid collection around the liver. The imaging findings were primarily suggestive of an abscess. Another possibility would be a tumor with central necrosis. Additionally, there were small para-aortic lymph nodes with diameter <1 cm as well as mild splenomegaly (spleen diameter 13.5 cm). (b) Follow-up ultrasonography imaging a week after having the drainage catheter in situ: residual abscess (red arrow) cavity with dimensions of 5.35 x 1.42 cm with minimal effusion and air. (c) Light-brown abscess fluid sample, after CT-guided drainage. (d) Patient's panoramic radiograph with the absence of abscesses.
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Abdominal ultrasonography showed a sizable liver lesion (cyst containing) confirmed by abdominal computed tomography (CT) scan (Fig. 1a). The abscess was drained under CT guidance and the fluid's biochemistry examination (Fig. 1c) was compatible with exudative etiology (pus; WBCs: 83.600/mul, neutrophils (#): 48 400, glucose 0 mg/dl, protein: 5.49 g/dl and LDH fluid/serum ratio: 8.16). Dentist referral concluded to a poor oral hygiene and an increased plaque deposition (Fig. 1d). Follow-up with an ultrasound a day before removing the drainage catheter showed a residual abscess cavity (dimensions of 5.3 x 1.4 cm) with minimal effusion and air (Fig. 1b).