A 58-year-old diabetic man presents with fever, right upper quadrant pain, and a 7 cm multiloculated liver abscess. Blood culture grows a gram-negative encapsulated organism that is hypermucoviscous on culture plate. The most likely causative organism is:

• A Escherichia coli
• B Klebsiella pneumoniae ✓
• C Streptococcus milleri group
• D Entamoeba histolytica

Explanation

Hypervirulent, hypermucoviscous Klebsiella pneumoniae has become the leading cause of monomicrobial pyogenic liver abscess in diabetic patients, particularly in Asia, and characteristically produces large abscesses with metastatic spread. E coli is associated with biliary and portal sepsis but lacks the mucoviscosity described. Streptococcus milleri is a gram-positive coccus, and Entamoeba produces amebic rather than pyogenic abscesses with anchovy paste pus.

Reference: Schwartz's Principles of Surgery, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.