LAUSR

A 63-year-old Aboriginal fisherman presented with fever and right hypochondriac pain for one week, preceded by nonbloody diarrhea two days prior. Physical examination revealed hepatomegaly, but no jaundice or other signs of chronic liver disease. Computed tomography (CT) of the abdomen revealed a large non-enhancing hypodense lesion at segments V, VI, VII, and VIII measuring 12.5 x 9.8 x 13.8 cm with septations noted within (Figure 1). Overall, the findings indicated a partially liquefied right liver lobe abscess. Percutaneous ultrasound-guided catheter drainage of the liver abscess was performed, and an odorless thick yellow-brown liquid, commonly described as "anchovy paste," was aspirated (Figure 2). Amoebic liver abscess was suspected because of the risk factors, single solitary liver lesion, and "anchovy paste" aspirate. Blood and aspiration cultures were negative, but amoebiasis serology was positive, confirming the diagnosis of amoebic liver abscess. The patient received intravenous metronidazole 500 mg every eight hours for a total of 10 days. A repeat CT scan revealed that the liver abscess had resolved three months later.