Multiple liver abscesses caused by Streptococcus intermedius

A 40-year-old woman without any clinical history was admitted for fever and discomfort in her right upper abdomen for 2 weeks.She denied headaches,recent travel,recent dental procedures,and recreational drug use.She was noted to have dental caries.Physical examination revealed tenderness in the right upper abdomen and percussion pain in the hepatic area.The white cell count was 15.7×10^(9)/L,with 83.1%neutrophils.Abdominal plain computed tomography(CT)revealed that the liver was full of multiple low-density cysts.Enhanced CT revealed no enhancement of the central necrotic areas but revealed uneven enhancement of the cystic walls(yellow arrows)and edema of the surrounding liver parenchyma(Figure 1A).