Miliary abscess of the liver represents a rare presentation of multiple liver abscesses. They often occur in immunosuppressed patients, or those with underlying liver disease. We report the case of a 22-year-old patient, without known immunodeficiency factors, surgical history or notion of tuberculous contacts, who was admitted for generalized peritonitis and ileal perforation. An ileostomy was performed. The infectious syndrome persisted in post-operative period, associated with painful hepatomegaly. An contrast-enhanced abdominal CT scan led to the diagnosis of miliary abscess of the liver. A blood culture isolated Escherichia coli. The treatment included antibiotics and the clinical evolution was favorable. The follow-up abdominal CT scan was normal. Intestinal continuity was restored without complications. Miliary abscess of the liver is rare and requires rapid diagnosis. The treatment is based on antibiotic therapy.
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