A 36-year-old man is brought to the emergency department because of right upper abdominal pain and anorexia that began 3 days ago. The pain is nonradiating and has no alleviating or exacerbating factors. He does not have nausea or vomiting. The patient lives in Ohaio and has no history of international travel. His temperature is 38.8°C (101.8°F), pulse is 85/min, respirations are 14/min, and blood pressure is 120/75 mm Hg. Lungs are clear to auscultation. He has tenderness to palpation in the right upper quadrant. Laboratory studies show elevated aspartate and alanine aminotransferases. Imaging studies reveal a fluid-filled cavity within the right lobe of the liver. Which of the following microorganism/route combinations is most likely to be the cause of this patient's infection?

Question

A 36-year-old man is brought to the emergency department because of right upper abdominal pain and anorexia that began 3 days ago. The pain is nonradiating and has no alleviating or exacerbating factors. He does not have nausea or vomiting. The patient lives in Ohaio and has no history of international travel. His temperature is 38.8°C (101.8°F), pulse is 85/min, respirations are 14/min, and blood pressure is 120/75 mm Hg. Lungs are clear to auscultation. He has tenderness to palpation in the right upper quadrant. Laboratory studies show elevated aspartate and alanine aminotransferases.  Imaging studies reveal a fluid-filled cavity within the right lobe of the liver. Which of the following microorganism/route combinations is most likely to be the cause of this patient's infection?

Quizplus · Accepted Answer

Eductional Objective: Staphylococcus aureus can cause hepatic abscesses via hematogenous seeding of the liver.  Enteric bacteria (eg, Escherichia coli, Klebsiella, and enterococci) can cause hepatic abscesses by ascending the biliary tract (ie, ascending cholangitis), portal vein pyemia, or direct invasion from an adjacent area (eg, cholecystitis).

A 36-Year-Old Man Is Brought to the Emergency Department Because