Fig. 12
From: Parasitic diseases as a cause of acute abdominal pain: imaging findings
A 49-year-old woman was admitted to the emergency department with a 1-week history of fever, shortness of breath, and weight loss. Physical examination revealed tachycardia. Increased serum level of acute phase reactants, eosinophilia, and increased level of liver enzymes were evident at blood analysis. a–c Axial contrast-enhanced CT images demonstrate periportal fat tissue stranding (arrowheads, a) and parenchymal hypodensity affecting right liver lobe (arrows, a, b). Areas of decreased parenchymal attenuation scattered at the periphery of the liver were also noted on CT (asterisks, a–c). The presence of complex pleural effusion (black asterisks) containing nodular (arrowheads, b) and linear (long arrows, b) areas of contrast enhancement, was consistent with pleural involvement. Liver biopsy revealed liver injury and the presence of eosinophilic infiltration. CT image at the level of liver dome demonstrates the parenchymal involvement (asterisks, c). d Sagittal reformatted T1-weighted inversion-recovery MR image obtained 10 min following IV gadolinium-based contrast agent injection, shows biventricular apical thrombus (asterisks) and subendocardial contrast enhancement (arrows) suggestive of Loeffler’s endocarditis. The definitive diagnosis of the Toxocara infection was made by serological tests