Primary hepatic actinomycosis

Fever of 10 mo duration in a man of 35 yr was discovered at the time of a second laparatomy to be caused by actinomycotic infection of the liver. Actinomycosis of the liver usually presents as large single or as multiple abscesses. In this patient only nonspecific cellular infiltrates of the liver were found in liver biopsies performed after 4 mo of fever. Not until 10 mo had elapsed were miniscule liver abscesses detected. It took an average of 8 mo to make a diagnosis in our patient and in 6 others like him reported since 1928. Exploratory surgery was required for diagnosis in all of them.