Recurrent Liver Abscess in a Non-toxic Patient

Area of Science:

• Hepatology
• Infectious Diseases
• Radiology

Background:

• Liver abscesses can present asymptomatically or with severe sepsis.
• Recurrence of pyogenic liver abscesses is uncommon, particularly after a long asymptomatic interval.

Observation:

• A patient presented with flu-like symptoms and jaundice, 10 years after a previous asymptomatic liver abscess.
• Laboratory tests revealed elevated liver enzymes and bilirubin.
• Triple-phase CT identified a 2.8 cm right liver lobe mass with linear enhancement.

Findings:

• Abscess aspiration and culture confirmed *Escherichia coli* as the causative agent.
• The recurrent abscess was in the same location as the prior infection.
• The same bacterial species, *E. coli*, was identified in both abscess episodes.

Implications:

• This case underscores the possibility of late recurrence of pyogenic liver abscesses, even in asymptomatic individuals.
• It emphasizes the importance of considering prior medical history, including previous liver abscesses, in diagnosis.
• The findings suggest that *E. coli* liver abscesses may have a potential for long-term recurrence in the same hepatic location.