Liver abscess in the caudate lobe caused by Klebsiella pneumoniae: a rare case report and literature review

BMC Infect Dis. 2024 Jul 19;24(1):708. doi: 10.1186/s12879-024-09569-6.

Abstract

Background: K. pneumoniae liver abscess (KPLA) mostly involves the right lobe. We present a case of K. pneumoniae caudate liver abscess with invasive liver abscess syndrome (ILAS) was rarely identified.

Case presentation: A 53-year-old man with elevated glycated hemoglobin with chills, rigors and a fever of five days. The patient presented with tachycardia and fever. Physical examination revealed tenderness over the right abdomen was elicited. In particular, the inflammatory markers were markedly elevated, and computerized tomography (CT) showed pulmonary abscess, pulmonary embolism and caudate liver abscess. The patient's sequential organ failure assessment (SOFA) score was 10 points. Klebsiella pneumoniae was isolated from sputum, urine and blood. With the suspicion of liver abscesses, ILAS and sepsis. The patient was successfully treated with antibiotics. He returned to close to his premorbid function.

Conclusion: K. pneumoniae caudate liver abscess was rare. This is the first detailed report of K. pneumoniae caudate liver abscess with invasive liver abscess syndrome. Patients with cryptogenic K. pneumoniae liver abscess are advised to undergo an examination of intestinal barrier function. The study indicates that in patients with K. pneumoniae liver abscess, a caudate liver abscess size of ≤ 9.86 cm² may be characteristic of those suitable for conservative treatment of invasive liver abscess syndrome.

Keywords: Caudate liver lobe; Invasive liver abscess syndrome; Liver abscess; Sepsis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents* / therapeutic use
  • Humans
  • Klebsiella Infections* / complications
  • Klebsiella Infections* / diagnosis
  • Klebsiella Infections* / drug therapy
  • Klebsiella Infections* / microbiology
  • Klebsiella pneumoniae* / isolation & purification
  • Liver Abscess* / diagnostic imaging
  • Liver Abscess* / drug therapy
  • Liver Abscess* / microbiology
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents