Kosin Med J.  2020 Jun;35(1):69-75. 10.7180/kmj.2020.35.1.69.

Klebsiella pneumoniae-induced Liver Abscess Complicated with Septic Pulmonary Embolism in a Non-diabetic Adult

Affiliations
  • 1Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
  • 2Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea

Abstract

A 72-year-old non-diabetic man was admitted to the intensive care unit because of liver abscess, cholecystitis, and septic shock. He underwent percutaneous catheter drainage and received intravenous antibiotics. Shock was improved, and the patient’s fever subsided. Klebsiella pneumoniae was isolated in blood and bile cultures. However, he suddenly developed dyspnea and oxygen desaturation. Chest computed tomography scan revealed multifocal ground-glass opacities with consolidation with peripheral preponderance. Appropriate antibiotic therapy was provided for 2 weeks. The patient recovered fully, and cholecystectomy was then performed. Herein, we report a case of K. pneumoniae-induced liver abscess complicated with septic pulmonary embolism in a non-diabetic patient.

Keyword

Klebsiella pneumonia; Liver abscess; Pneumonia

Figure

  • Fig. 1 Initial chest radiography revealed subtle linear opacity in both lower lung fields.

  • Fig. 2 Abdominal computed tomography scan revealed a 4.5-cm liver abscess in segment 4 of the liver (A) and a dilatated gallbladder with diffuse inflammatory thickening (B).

  • Fig. 3 Chest computed tomography scan revealed multifocal ground-glass opacities with consolidation in both upper lung fields (A), the right middle lung (B), and the lingular segment of the left upper lung with peripheral preponderance (C).


Reference

1. Chung DR, Lee SS, Lee HR, Kim HB, Choi HJ, Eom JS, et al. Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect. 2007; 54:578–83.
Article
2. Siu LK, Yeh KM, Lin JC, Fung CP, Chang FY. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis. 2012; 12:881–7.
Article
3. Lim SW, Lee EJ, Lee SW, Kim SM, Kim JH, Kim BJ, et al. Clinical significance of Klebsiella pneumoniae in liver abscess. Korean J Gastroenterol. 2003; 42:226–31.
4. Chou DW, Wu SL, Chung KM, Han SC. Septic pulmonary embolism caused by a Klebsiella pneumoniae liver abscess: clinical characteristics, imaging findings, and clinical courses. Clinics (Sao Paulo). 2015; 70:400–7.
Article
5. Lee SJ, Cha SI, Kim CH, Park JY, Jung TH, Jeon KN, et al. Septic pulmonary embolism in Korea: Microbiology, clinicoradiologic features, and treatment outcome. J Infect. 2007; 54:230–4.
Article
6. Kamano Y, Ohashi H, Kikuchi T, Watanabe K, Kitahara M. Liver abscess and Aeromonas bacteremia with septic pulmonary embolism. Intern Med. 2003; 42:1047–9.
Article
7. Ryung YJ, Yeop Y, Na JY, Sook LH, Ho JG, Ina J. Klebsiella pneumoniae Liver abscess complicated with septic pulmonary embolism. J Korean Geriatr Soc. 2013; 17:239–43.
Article
8. Chung DR, Lee SS, Lee HR, Kim HB, Choi HJ, Eom JS, et al. Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect. 2007; 54:578–83.
Article
9. Lee KH, Moon SY, Kim IA, Kwon SY, Kim JH, Choe WH, et al. A Case of Delayedonset Multiple Metastatic Infection following Liver Abscess. Korean J Gastroenterol. 2015; 66:237–41.
10. Kim GS, Lee JH, Choi SA, Lim SR. A case of Klebsiella pneumoniae liver abscess complicated with brain abscess and endophthalmitis. J Korean Neurol Assoc. 2005; 23(5):78–80.
11. Yoon HS, Lee MH, Lee SJ, Kim KY, You YP, Jung DY, et al. A Case of pyogenic liver abscess complicated with endophthalmitis. Korean J Gastroenterol. 2001; 38:120–3.
12. Chiu CT, Lin DY, Liaw YF. Metastatic septic endophthalmitis in pyogenic liver abscess. J Clin Gastroenterol. 1988; 10:524–7.
Article
13. Yang PW, Lin HD, Wang LM. Pyogenic liver abscess associated with septic pulmonary embolism. J Chin Med Assoc. 2008; 71:442–7.
Article
14. Marrie TJ, Poulin-Costello M, Beecroft MD, Herman-Gnjidic Z. Etiology of community-acquired pneumonia treated in an ambulatory setting. Respir Med. 2005; 99:60–5.
Article
15. Fung CP, Chang FY, Lee SC, Hu BS, Kuo BI, Liu CY, et al. A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? Gut. 2002; 50:420–4.
Article
16. Lin YT, Wang FD, Wu PF, Fung CP. Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics. BMC Infect Dis. 2013; 13:56.
Article
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