Actinomycotic liver abscess. Case report and literature review

A 28-year-old male with hepatic actinomycosis presented with several months of anorexia, weight loss, fever, night sweats, and mild right upper quadrant abdominal tenderness. Despite normal liver function tests, hepatic involvement was demonstrated by imaging studies. A liver biopsy and ultrasound-guided aspirate were, however, unrewarding. Laparotomy was, therefore, necessary to establish a definitive diagnosis. The patients was then successfully treated with intravenous penicillin followed by oral clindamycin. This case is presented to illustrate the diagnostic difficulties that may be encountered in such patients with hepatic actinomycosis.