Primary hepatic actinomycosis is one of the chronic abscess-forming infections of the liver. Accurate diagnosis is frequently delayed due to its indolent course and nonspecific clinical and radiological manifestations. We report a case of a 57-year-old man presenting with asymptomatic multiple hepatic masses on follow-up abdominal computed tomography performed 1 year after stomach cancer surgery. Although a percutaneous liver biopsy procedure was conducted twice in order to obtain confirmative pathology, only a nonspecific organizing abscess with plasma cell infiltration was revealed, without identification of any organism in the tissue cultures. Ultimately, actinomycosis was diagnosed following the detection of sulfur granules on open surgical biopsied tissue. This case suggests that primary hepatic actinomycosis should be considered as one of the possible causes for enigmatic inflammatory lesions of the liver.
Actinomycosis/*diagnosis/drug therapy/microbiology ; Anti-Bacterial Agents/therapeutic use ; Biopsy, Needle ; Humans ; Liver Abscess/complications ; Liver Diseases/*diagnosis/microbiology/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient.
Aspergillosis/*diagnosis ; Aspergillus/isolation & purification ; Bone Transplantation ; Cervical Vertebrae/microbiology/pathology/surgery ; Humans ; *Immunocompromised Host ; Liver Transplantation ; Lumbar Vertebrae/microbiology/pathology/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Postoperative Complications/diagnosis/microbiology/surgery ; Rare Diseases ; Spondylitis/*microbiology/surgery ; Thoracic Vertebrae/microbiology/pathology/surgery