Honeycomb liver abscess

A 65-year-old Japanese woman was presented with a 2-day history of fever. The patient had undergone a surgery for uterine myoma 20 years prior. Drug history was unremarkable except for acetaminophen use. On admission, her temperature was 39.9 C; she had tachycardia (117 beats/min) and no abdominal pain. A contrast-enhanced abdominal computed tomography revealed multiple multiloculated low-density areas in the liver (Figs. 1 and 2); pyogenic liver abscess was consequently suspected. Percutaneous drainage of the liver abscess was performed, although drainage was incomplete. Blood cultures on admission and liver abscess cultures grew Klebsiella pneumoniae. Subsequently, ceftriaxone and metronidazole were administered for the first week. However, since the fever persisted despite the susceptibility of K. pneumoniae to the antibacterials, meropenem was administered