A 27-year-old man presented with a 1-month history of epigastric pain, weight loss and night sweats following a hiking trip to Bolivia. He was pyrexial at 37.8ºC, with a pulse rate of 90 beats/min and blood pressure of 128/83 mmHg. He was mildly tender over the epigastrium. Laboratory investigations showed a mildly elevated white blood cell count of 11.82 x 109/L with an eosinophilia of 4.82 x 109/L (normal range 0.00 to 0.72 x 109/L), erythrocyte sedimentation rate of 36 mm/hr and normal liver function test. His stool culture was negative for ova, cysts or trophozoa. He was investigated with an intravenous contrast enhanced computed tomography (CT) (Fig. 1) and later magnetic resonance imaging (MRI) of the liver (Fig. 2).
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