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A 53-year-old man with Crohn's disease, short-bowel syndrome that required total parenteral nutrition, a history of recurrent catheter infections, hypertension, chronic renal insufficiency, and mitral regurgitation presented with fevers of 2 weeks' duration. He had elevated liver enzyme levels (aspartate aminotransferase, 45 U per liter; alanine aminotransferase, 97 U per liter; alkaline phosphatase, 679 U per liter; and total bilirubin, 7.3 mg per deciliter [125 µmol per liter]). Abdominal ultrasonography and endoscopic retrograde cholangiopancreatography showed no abnormalities. Blood was obtained for culture, and the patient was discharged while receiving intravenous levofloxacin. He returned after 5 days because of continued fevers, . . . [Full Text of this Article] |