You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
the following is an unusual case of multiple liver abscesses that grew fusobacterium necrophorum , an anaerobic gram - negative rod that is commonly found among human oropharyngeal flora .
an 18-year - old , previously healthy college student presented to our hospital with a chief complaint of abdominal pain .
a computed tomography scan of the abdomen with iv contrast at an outside institution showed multiple hepatic abscesses ( fig .  1 ) .
aside from several days of upper respiratory symptoms and odynophagia , a review of systems was negative .
the patient was tachycardic , normotensive and febrile to 39.2c . aside from minimal right upper quadrant tenderness , the remainder of the physical examination was normal .
laboratory data showed leukocytosis of 25 000/l , erythrocyte sedimentation rate ( esr ) 66 , international normalized ratio 1.41 , aspartate transaminase 32 , alanine transaminase 50 , alkaline phosphatase 147 and direct bilirubin 0.5 .
the patient was started on broad - spectrum antibiotics and underwent ultrasound - guided percutaneous drainage of the largest hepatic abscess , which measured 5 cm ( fig . 
two additional drainage procedures were performed on hospital days 7 and 9 , which ultimately drained 15 of the collections and removed > 120 ml of purulent fluid ( fig . 
no organisms grew from cultures of the subsequent hepatic aspirations , and the patient demonstrated significant clinical improvement with resolution of pain and fever .
repeat ultrasound on hospital day 12 showed complete resolution of most hepatic abscesses with no new focal lesions .
antibiotic coverage was further narrowed , and the patient was discharged on a 6-week total course of antibiotics . at the time of this report , the patient continues to do well at home .
pyogenic liver abscesses in the adolescent population are uncommon , particularly in patients who are not immunocompromised and are from developed countries .
the annual incidence of pyogenic liver abscesses is 3.6 per 100 000 in the usa , and the majority represents hepatic abscesses in children [ 1 , 2 ] .
the typical clinical manifestations of pyogenic hepatic abscesses are fevers ( 89.6% ) , right upper quadrant pain ( 72.2% ) and chills ( 69.0% ) .
a single abscess is often insidious in presentation , but multiple abscesses may present more acutely .
, standard treatment was open surgical debridement , however ; with improved antibiotic coverage and image - guided catheter drainage technique , most pyogenic abscesses can successfully be managed with intravenous antibiotics and percutaneous drainage . 

figure  1:multiple lucencies noted within the liver consistent with abscesses along with a thickened gallbladder . 
 figure  2:(a ) ultrasonography following initial drainage showing several residual abscesses within the liver , but decreased in number compared with prior exam .
( b and c ) ultrasound demonstrating interval improvement in the multiple liver abscesses , with the majority becoming smaller in size and some demonstrating complete resolution .
( a ) ultrasonography following initial drainage showing several residual abscesses within the liver , but decreased in number compared with prior exam .
( b and c ) ultrasound demonstrating interval improvement in the multiple liver abscesses , with the majority becoming smaller in size and some demonstrating complete resolution .
classically , liver abscesses in children were described as secondary to a perforated appendicitis ; though there is reported increasing incidence of seeding from the biliary tract .
the abscesses are thought to result from organisms via three major routes : the biliary tract ( 60% ) , portal vein ( 6% ) and the hepatic artery ( 10% ) . in assessing our patient , we primarily considered these routes of transmission when trying to isolate a potential source of infection , with the most common microorganisms isolated from pyogenic liver abscesses being streptococcus milleri , staphylococcus aureus , e. coli , klebsiella pneumonia and enterobacter .
when no predisposing pathology was found , we began to consider other less likely routes of transmission .
a less common microorganism found in pyogenic liver abscesses is f. necrophorum , a gram - negative obligate anaerobe that is found in the oropharynx , gastrointestinal tract and genitourinary tract .
fusobacterium as an isolated infection is relatively rare ; accounting for < 1% of bacteremia in all adults in the usa .
it was first described in animals and there have been very few reports in the literature of human infection .
fusobacterium necrophorum is most commonly associated with lemierre 's syndrome , a potentially life - threatening illness that begins as an oropharyngeal infection that leads to internal or external jugular venous thrombophlebitis and progresses to sepsis with embolic metastasis to the lungs and other organs .
it is often referred to as the  forgotten disease because the widespread use of antibiotics has decreased the incidence , though in the last decade it has begun to re - emerge .
a recent polymerase chain reaction study detected the organism in throat swabs from 21% of healthy young adults .
interestingly , these cases seem to be increasing incidence with decreasing usage of antibiotics , especially with practice guidelines that effectively require demonstration of group a streptococcus before prescribing an antibiotic in children and adults . to date
, there have been only two reports that describe liver abscesses in previously healthy adolescent caused by f. necrophorum without associated lemierre 's .
there are only four reports overall that suggest oropharyngeal source as a cause for hepatic abscesses . in the presented case
this is a reminder that one must consider f. necrophorum and oropharyngeal bacterial seeding in an otherwise healthy patient presenting with abscess .
several reports have indicated a relationship between organ abscesses and oral infections , poor oral health and dental interventions or oral prophylaxis . with periodontitis rapidly becoming one of the most common chronic infections in the world ,
currently , there is no standard duration of antibiotic therapy for the treatment of f. necrophorum liver abscesses .
the current literature states that patients may require between 4 and 6 weeks of antibiotic therapy with 26 weeks of parenteral therapy .
fusobacterium is highly sensitive to antibiotics ; however , the inflammatory response the body mounts can cause significant illness thus requiring long - term treatment . in the case of our patient , while he was treated with antibiotics for negative cultures , it was likely the repeated aspirations that diminished his inflammatory response . additionally , the extent of percutaneous drainages required for pyogenic liver abscesses has not been clearly delineated in the literature .
described an adolescent with an f. necrophorum liver abscess who underwent two ct - guided percutaneous drainages with antibiotic treatment and was successfully treated .
the difference between this report and our patient was the decision to leave a catheter in place .
the utility of a percutaneous drainage catheter was not explored in this case report ; and it is possible that a catheter would have been beneficial to our patient and decreased the number of drainages that he underwent . in conclusion , this case report represents an unusual presentation of fusobacterium infection leading to hepatic abscess . given the increased incidence of oropharyngeal infections in children and adolescents , one must consider this and other oropharyngeal sources in the differential for hepatic abscesses with no evidence of immunocompromise or prior intra - abdominal procedures .
dr . gregg has received an honorarium for teaching atls for the american college of surgeons . all other authors report no conflict of interest .
an 18-year - old , previously healthy man admitted with abdominal pain , high - grade fevers , nausea and emesis was found to have multiple hepatic abscesses . 
 aspiration cultures grew fusobacterium necrophorum , a rare bacterium causing potentially fatal liver abscesses in humans . 
 following sequential percutaneous drainages and narrowing of antibiotics , the patient was discharged on a 6-week antibiotic course and showed no signs of infection . a week after presentation it was discovered that he had experienced upper respiratory symptoms and sore throat prior to presentation . 
 because oropharyngeal infections are a potential source of bacteremia , they must be considered in the differential diagnosis of patients presenting with hepatic abscesses and no evidence of immunocompromise .