Case 325: Bacterial Infection

Diagnostic Category:

Clinical Presentation:

45 year old man with common variable immunodeficiency and recent history of night sweats and unintentional weight loss. Work-up showed elevated LFT's.

CT: Atypical bacterial infection

Imaging Findings:

CT of infection with filarious bacteria, likely Actinomyces: subtle but stronger and more central zonal perfusion abnormality of the right hepatic lobe, compared to the MR, which was acquired approximately 2 months after this CT. Note that the abnormal enhancement does not adhere to vascular territories, but demonstrates a rather curvilinear shape, representing the front of bacteria induced parenchymal alterations. Compare to expansion of changes on MR.

These CT images are obtained from a CT chest the patient had for shortness of breath.