Infected hepatic cyst in a patient with multiple hepatic cysts: report of a case diagnosed by change of ultrasonographic findings

Liver cysts are commonly observed, but infection of a liver cyst is a rare complication. Although patients have clinical symptoms, such as a high-grad e fever and abdominal pain, diagnosing an infected cyst by abdominal ultras onography, computed tomography (CT) with contrast medium and magnetic reson ance imagings (MRI) is not always easy. We experienced an unusual case who had only clinical symptoms, such as high-grade fever and a right quadrant a bdominal pain, but no imaging findings when admitted, Careful observation u sing ultrasonography once a week revealed signs of an infected cyst contain ing echogenic fluid 32 days after admission. We performed percutaneous tran shepatic cystic drainage. When a patient has liver cysts and complains of h igh-grade fever and abdominal pain, liver cysts should be considered as a f ocus of sepsis, and we recommend repeat use of ultrasonography or CT, even no typical findings occur the first time, (C) 2000 Lippincott Williams & Wi lkins.