Hepatic or Splenic Brucelloma (Chronic Hepatosplenic Brucella Abscess)

Clinical features:

(1) remote exposure history (may be decades)

(2) nonspecific systemic features (fever, malaise, weight loss)

(3) upper abdominal pain

Serology testing will help to identify a patient who should have additional testing (tube agglutination test, other)

Patterns on imaging studies - hypodense with peripheral enhancement

(1) solitary abscess with central calcifications

(2) multiple smaller abscesses with absence of calcifications

Blood and liver aspirate cultures are often negative, but PCR is more sensitive.