Radiological Case of the Month

CLINICAL HISTORY.—This 11-year-old Negro girl was admitted to the hospital following an automobile accident in which she received a closed fracture of the right femur and clavicle, multiple superficial abrasions, and blunt trauma to the abdomen. Thirty-six hours following admission she complained of severe pain in the right upper quadrant of the abdomen associated with a temperature of 106 F (41.1 C), Salmonella B bacteremia, and a falling hematocrit reading. Exploratory laparotomy revealed a large laceration involving the entire right lobe of the liver and extending into the left lobe with no active bleeding sites. Drains were placed anteriorly and posteriorly and were removed on the 12th postoperative day. Although the patient was given ampicillin and kanamycin sulfate, cultures of blood, tracheal aspirate, and urine on the 7th postoperative day, obtained because of temperature spike, grew Klebsiella-Enterobacter. Antibiotic treatment was changed to chloramphenicol, but as Klebsiella bacteremia persisted,