Liver: pyogenic abscess organism: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Liver: pyogenic abscess organism

Sample item

A 54-year-old diabetic man has fever and a solitary 6 cm right lobe liver abscess. Aspirated pus is thick and yellow, and culture grows a mucoid lactose-fermenting Gram-negative bacillus. Three days later he complains of eye pain and blurred vision. Which organism is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Klebsiella pneumoniae

Hypervirulent Klebsiella pneumoniae is a leading cause of cryptogenic pyogenic liver abscess in diabetic patients in Asia and is notable for metastatic spread, especially endophthalmitis and meningitis. Management is percutaneous drainage plus intravenous antibiotics, with urgent ophthalmic assessment if eye symptoms appear.

Option by option

  • A. Entamoeba histolytica

    Entamoeba gives sterile anchovy-sauce pus with no bacteria on culture.

  • B. Echinococcus granulosus

    Echinococcus is a tapeworm cyst that would not grow on routine bacterial culture.

  • C. Klebsiella pneumoniae (correct)

    Correct. A mucoid lactose-fermenting bacillus with abscess and endophthalmitis in a diabetic suggests Klebsiella.

  • D. Staphylococcus aureus

    Staphylococcus aureus is a Gram-positive coccus, causing multiple abscesses in children or after bacteraemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Klebsiella pneumoniae. Hypervirulent Klebsiella pneumoniae is a leading cause of cryptogenic pyogenic liver abscess in diabetic patients in Asia and is notable for metastatic spread, especially endophthalmitis and meningitis.

Why is "Entamoeba histolytica" not the answer?

Entamoeba gives sterile anchovy-sauce pus with no bacteria on culture.

Why is "Echinococcus granulosus" not the answer?

Echinococcus is a tapeworm cyst that would not grow on routine bacterial culture.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus aureus is a Gram-positive coccus, causing multiple abscesses in children or after bacteraemia.

What concept does this question test?

It tests Liver: pyogenic abscess organism in General Surgery. Management is percutaneous drainage plus intravenous antibiotics, with urgent ophthalmic assessment if eye symptoms appear.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Liver: pyogenic abscess organism?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.