Dear Editor, An 81-year-old male presented to emergency department with fever off and on for more than one month. He had the medical history of malignantpoorly differentiated neuroendocrine tumors, hypertension and type-2 diabetes mellitus. One month ago, he was admitted for fever and diarrhea. Infectious diarrhea due to Salmonella enteritidis was diagnosed according to the positive culture result of blood and stool. After antibiotic treatment with flomoxef according to antibiotic susceptibility test, his clinical condition gradually improved, and was discharged uneventfully. However, he suffered from abdominal pain over right upper quadrant (RUQ) and low grade fever again one week later after discharge. At emergency department, his vital signs were a body temperature of 37.7 ^o C, pulse rate of 100/min, respiratory rate of 16/min and blood pressure of 147/75 mmHg. Physical examinations were unremarkable except for abdominal tenderness over RUQ. The results of laboratory examinations were as follows: white blood cell count, 17900 cells/mm ³ , and C-reactive protein, 106.9 mg/L (reference value, <5 mg/L). Radiography of the abdomen revealed mottled gas collection over RUQ (Figure 1, arrow). The abdomen computed tomography (CT) showed that a mass with gaseous content and size of 5.8×5.2 cm over S6 (Figure-2, arrow). Emphysematous liver abscess by S.enteritidis was impressed. Therefore, he received percutaneous drainage and antibiotic with ceftriaxone for liver abscess. Follow-up of abdominal echo showed gradually shrinkageof liver abscess,and the percutaneous drainage was smoothly removed.

Finally, he received a total antibiotic course of four weeks included an initial parenteral ceftriaxone and further oral moxifloxacin.

Most cases of S. enteritidis infection is mainly limited to the intestinal tract, but sometimes S. enteritidis may cross the mucosal barrier to disseminate ( 1 ). Localized infection of the liver is a rare complication of salmonella ( 1 , 2 ). Prompt drainage and appropriate antibiotic treatment are essential for the treatment of liver abscess. However, the clinical manifestation of liver abscess may be non-specific, and lead to delayed diagnosis. In most of the time, CT or ultrasound is the choice of diagnostic method. Sometimes plain radiography may provide useful information for diagnosis, such as shown in our case (Figure-1).