Case 46. 
Alkaligenes xylisoxidans-induced liver abscess (52 y-o F)
         
    Surgically resected liver with irregularly fused abscess, manifesting 5 months after cholecystectomy    
         
   
Key words :  Alkaligenes xylisoxidans, liver abscess
   
     
 
     
CT scan shows irregular-shaped large abscess cavities in the right lobe of the liver.   Fused abscess cavity seems to extend along the biliary tree in the liver (gross findings). Alkaligenes xylisoxidans was repeatedly cultured from the drain tube exudate.
     
 
     
Suppurative granuloma with central accumulation of neutrophils is formed in the liver (HE, low power).   Epithelioid granuloma with Langhans-type giant cells surrounds the central neutrophilic exudate (HE. high power).