Aggregatibacter aphrophilus , a fastidious Gram-negative member of the Haemophilus , Aggregatibacter , Cardiobacterium , Eikenella , and Kingella group, is an exceptionally rare cause of hepatic abscess, particularly in immunocompetent individuals. We describe a case of a healthy, middle-aged man who presented with a 5-day history of cyclical fevers, chills, and night sweats. Computed tomography imaging revealed a solitary hepatic lesion, initially suspicious for malignancy. Magnetic resonance cholangiopancreatography confirmed a hepatic abscess. Culture from a computed tomography-guided aspirate identified A. aphrophilus as the causative organism. Despite empiric broad-spectrum antibiotics and drainage, the patient continued to experience febrile episodes until culture-directed therapy led to clinical resolution. He received 3 weeks of intravenous ceftriaxone 2 g q24 h and PO metronidazole 500 mg q8 h and percutaneous drainage. Upon follow-up with infectious disease, no recurrence was noted upon review of repeat computed tomography imaging. This case highlights the importance of early microbiological identification and targeted treatment, even in healthy hosts.
Tran et al. (Thu,) studied this question.