The rim sign in hepatic abscess: case report and review of the literature.
We studied a previously healthy patient who presented with a 3-wk history of fever, flu-like symptoms and abdominal pain.


METHODS
Blood cultures were positive for Escherichia coli. A computed tomography (CT) scan revealed a 2-cm low-density focus in the right hepatic lobe. A technetium-99m-mebrofenin scan showed a photopenic area in the right hepatic lobe surrounded by a rim of activity greater than the adjacent parenchymal activity.


RESULTS
Gallbladder visualization was normal and the diagnosis of hepatic abscess was made. CT-guided percutaneous drainage of the lesion yielded six cc of pus, the culture of which grew E. coli, Prevotella and Bacteroides fragilis. Drainage and a 6-wk course of intravenous antibiotics were followed by clinical improvement and resolution of the abscess by CT.


CONCLUSIONS
The rim sign and its possible mechanism of causation in hepatic abscess are discussed in this report, together with a review of the literature.
McDonald
K L
KL
Department of Radiology, Mercy Hospital of Pittsburgh, Pennsylvania 15219-5168, USA.
Davani
M
M
D000814:Aniline Compounds; D016866:Bacteroidaceae Infections / Q000000981:diagnostic imaging; D001442:Bacteroides Infections / Q000000981:diagnostic imaging; D001441:Bacteroides fragilis; D004927:Escherichia coli Infections / Q000000981:diagnostic imaging; D005998:Glycine; D006801:Humans; D007098:Imino Acids; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D018720:Prevotella; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C034837:technetium Tc 99m mebrofenin; D005998:Glycine