An Uncommon Cause of Chest Pain: Multiloculated Hepatic Abscess in a Patient with Strongyloides Stercoralis Infection

Abstract

Liver abscesses are purulent collections in the liver parenchyma that result from bacterial, fungal, or parasitic infections. Infection can spread to the liver through the biliary tree, hepatic vein, or portal vein when an adjacent infection or trauma expands. We report a case of a 53-year-old male who presented to an ambulatory clinic for evaluation of substernal chest pain. He reported associated palpitations, chills, shortness of breath, and diaphoresis. An abdominal CT revealed a mass with multiple loculations in the right and caudate hepatic lobe consistent with an abscess. Blood cultures grew Klebsiella pneumoniae, and ova and parasite exams showed Strongyloides stercoralis larvae. After four weeks of antibiotic treatment, a follow-up abdominal CT demonstrated complete resolution of the hepatic abscess. This case is an unusual presentation of a hepatic abscess as the patient did not report abdominal symptoms.