A 42 year old man presents with pain in the right upper abdomen for 3 days, associated with a swinging fever, nausea and vomiting. No other symptoms are present.

His medical and drug histories are unremarkable. His history is otherwise significant only for multiple visits to India during the last one year. The last visit was around a month ago.

His full blood count shows a leukocyte count of 14,500/mm3, with 89% neutrophils.