Cutibacterium avidum caused a liver abscess after transarterial chemoembolization for hepatocellular carcinoma

An 83-year-old man was admitted to the hospital with a fever 10 days after undergoing transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma. The computed tomography (CT) scan showed a fluid collection in the liver near the lesion after TACE, and he was diagnosed with a liver abscess. Despite initial treatment with piperacillin-tazobactam, initiated on the day of admission, the abscess enlarged with persistent fever. Puncture drainage of the abscess was performed, and Gram stain revealed numerous Gram-positive rods. Cutibacterium avidum was detected in the drainage specimen. Post-drainage, his fever improved. His symptoms improved after drainage, and he remained free of recurrence as of this writing. Pyogenic liver abscesses caused by usual indigenous skin bacteria, such as staphylococci, can occur after TACE, but the one caused by C. avidum has never been reported. Transcutaneous interventions such as TACE could lead to liver abscesses caused by this rare organism.