Final answer:
The patient with a history of IV drug abuse and persistent fever, showing liver lesions on CT, likely requires broad-spectrum antibiotics and potential interventional radiology for drainage, alongside hospitalization and infectious disease consultation.
Step-by-step explanation:
The patient presenting with a history of intravenous drug use and persistent fever despite drainage of an upper extremity abscess suggests a complicated infection. The CT scan findings of multiple low-density lesions within both lobes of the liver with peripheral rim enhancement are concerning for a pyogenic liver abscess, although differential diagnoses could include other infections or even malignancies. Immediate treatment should include broad-spectrum antibiotics covering for Staphylococcus aureus and anaerobes, commonly associated with IV drug use. In addition, the patient may require interventional radiology for drainage of the liver abscesses, depending on their size and response to antibiotics. Hospitalization and infectious disease consultation are recommended for optimized care management and follow-up. Treatment should be started right away and tailored based on culture results and antibiotic sensitivities.