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A 64-year-old man with a history of colonic resection for adenocarcinoma six years earlier presented with weakness and abdominal discomfort of six months' duration. Computed tomography of the abdomen with administration of contrast material showed multiple hypodense lesions involving the liver. The process on the liver appeared to cross the capsule and peritoneal membrane (arrow, Panel A). There was a small lesion in the upper pole of the spleen. Cultures of a specimen obtained by fine-needle aspiration of a liver lesion showed only Actinomyces israelii (inset). The patient was started on intravenous ampicillin and sulbactam. After eight weeks, a prominent . . . [Full Text of this Article] |
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