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After blood culture specimens were obtained, I.V. metronidazole and ceftriaxone were administered. Magnetic resonance imaging demonstrated a hepatic abscess, and the patient underwent computed tomography-guided percutaneous drainage. Thirty-five milliliters of purulent fluid was obtained and sent to the lab for culture and sensitivity, which revealed Fusobacterium necrophorum (F. necrophorum), an anaerobic Gram-negative bacterium.
After receiving the culture and sensitivity test results, antibiotic therapy was changed to metronidazole and piperacillin/tazobactam. The patient responded well and was subsequently discharged. A follow-up evaluation revealed complete resolution of the hepatic abscess. The authors speculated that the oral cleaning in the dentist's office may have resulted in mucosal trauma that allowed this organism to enter the bloodstream.