A 48-year-old woman with fever with right lower abdominal pain after appendectomy 3 months ago was treated with triple cephalosporin and levofloxacin, which were ineffective. Ultrasound of the surgical area showed no abnormality, and gynecologic ultrasound and pelvic CT showed pelvic inflammatory disease. Anti-inflammatory treatment in obstetrics and gynecology department was ineffective. A whole-body PETCT scan was performed at a major hospital, but the diagnosis was still not clear. On examination, she found suspicious percussion pain in the right upper abdomen, and the diagnosis of liver abscess was clearly made by abdominal ultrasound, and the temperature was normalized after 3 days of anti-inflammatory treatment with high-dose triple cephalosporin combined with ornidazole, and the liver abscess was significantly reduced in one week. Hint: persistent fever after appendicitis should be considered the possibility of liver abscess, which may be caused by the bacteria at the appendix may enter the portal vein system from the appendiceal vein and lead to liver abscess.