Radiological diagnosis and management of a solitary tuberculous hepatic abscess

Abstract

Tuberculous hepatic abscesses are rare and usually associated with foci of infection in the lung or gastrointestinal tract (Leader, 1952). Primary hepatic abscesses, with no evidence of infection elsewhere, are even less common. To date only 13 cases have been described in the English language literature (Dhekne etal, 1987, Goh et al, 1987, Spiegel & Tuazon, 1984, Stevens & Little, 1987). The diagnosis is often elusive and made at laparotomy or post mortem. This case illustrates that the diagnosis may be made radiologically and then successfully managed by percutaneous drainage. A 32-year-old man was admitted with a 4-week history of lethargy, anorexia, weight loss and night sweats. Fourteen years previously a chest radiograph had been taken because of contact with a relative who had pulmonary tuberculosis. The radiograph was normal and he was not followed up.