title: Refractory primary hepatic actinomycosis with direct infiltration to the diaphragm and thorax: the usefulness of contrast-enhanced ultrasonography.
abstract: An 80-year-old man was admitted to our hospital with a diagnosis of primary hepatic actinomycosis determined based on a percutaneous aspiration biopsy. The abscesses and state of liquefaction were easily and effectively visualized on contrast-enhanced ultrasonography. Ampicillin/sulbactam was administered; however, lesions of hepatic actinomycosis suddenly infiltrated the diaphragm and right thorax six months later. A drainage tube was inserted into the right thoracic space, and the pleural effusion gradually decreased. The patient received continuous antibiotic therapy for nearly two years and remained free of hepatic actinomycosis on follow-up more than one year later.
authors.affiliation: The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Oe
authors.forename: Michihiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hiura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsuoka
authors.forename: Toru
authors.initials: T
authors.lastname: Matsuhashi
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Narita
authors.forename: Shintaro
authors.initials: S
authors.lastname: Abe
authors.forename: Akinari
authors.initials: A
authors.lastname: Tabaru
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hayashida
authors.forename: Hatsumi
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Masaru
authors.initials: M
authors.lastname: Harada
mesh_terms: D000196:Actinomycosis / Q000000981:diagnostic imaging* / Q000382:microbiology; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000000981:diagnostic imaging*; D006801:Humans; D007366:Intercostal Muscles / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D014463:Ultrasonography
chemical_list: D003287:Contrast Media