1887

Abstract

Introduction. Klebsiella pneumoniae liver abscess syndrome (KLAS) is characterized by bacteraemia, liver abscesses and metastatic infection caused by a hypervirulent strain of Klebsiella pneumoniae, usually belonging to the capsular serotype K1 or K2. Initially, KLAS was described in Eastern Asia; recently isolated cases have been reported from different parts of the world.

Case presentation. We describe the case of a woman with KLAS including meningeal, ocular and cutaneous metastatic infection and organ dysfunctions (coagulation abnormalities, thrombocytopenia and increased creatinine level). The identification of a hypermucoviscous strain of Klebsiella pneumoniae was possible by culture from one of the cutaneous emboli and subsequently confirmed by blood cultures. The patient fully recovered after abscess drainage and prolonged antibiotic treatment.

Conclusion. We have pointed out about the importance of sampling each septic focus in order to identify the aetiology of a disseminate infection.

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2018-04-12
2019-10-23
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References

  1. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL et al. Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 2007;45:284–293 [CrossRef][PubMed]
    [Google Scholar]
  2. Zoricic I, Vukusic D, Sever M, Lojo N, Baric M. Pyogenic liver abscess caused by Klebsiella pneumoniae. Acta Medica Croatica 2013;66:321–325
    [Google Scholar]
  3. Moore R, O'Shea D, Geoghegan T, Mallon PW, Sheehan G. Community-acquired Klebsiella pneumoniae liver abscess: an emerging infection in Ireland and Europe. Infection 2013;41:681–686 [CrossRef][PubMed]
    [Google Scholar]
  4. Qian Y, Wong CC, Lai SC, Lin ZH, Zheng WL et al. Klebsiella pneumoniae invasive liver abscess syndrome with purulent meningitis and septic shock: a case from mainland China. World J Gastroenterol 2016;22:2861–2866 [CrossRef][PubMed]
    [Google Scholar]
  5. Thomsen RW, Jepsen P, Sørensen HT. Diabetes mellitus and pyogenic liver abscess: risk and prognosis. Clin Infect Dis 2007;44:1194–1201 [CrossRef][PubMed]
    [Google Scholar]
  6. Popescu GA, Tanase D, Petrescu AM, Florea D. Liver abscess associated with severe myopathy caused by Klebsiella pneumoniae serotype K1 in Romania. J Infect Dev Ctries 2014;8:1491–1493 [CrossRef][PubMed]
    [Google Scholar]
  7. Yeoh KG, Yap I, Wong ST, Wee A, Guan R et al. Tropical liver abscess. Postgrad Med J 1997;73:89–92 [CrossRef][PubMed]
    [Google Scholar]
  8. Lin JC, Chang FY, Fung CP, Xu JZ, Cheng HP et al. High prevalence of phagocytic-resistant capsular serotypes of Klebsiella pneumoniae in liver abscess. Microbes Infect 2004;6:1191–1198 [CrossRef][PubMed]
    [Google Scholar]
  9. Shon AS, Bajwa RP, Russo TA, Hypervirulent RTA. Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: a new and dangerous breed. Virulence 2013;4:107–108 [CrossRef][PubMed]
    [Google Scholar]
  10. Cerwenka H. Pyogenic liver abscess: differences in etiology and treatment in Southeast Asia and Central Europe. World J Gastroenterol 2010;16:2458–2462 [CrossRef][PubMed]
    [Google Scholar]
  11. Anstey JR, Fazio TN, Gordon DL, Hogg G, Jenney AW et al. Community-acquired Klebsiella pneumoniae liver abscesses – an "emerging disease" in Australia. Med J Aust 2010;193:543–545[PubMed]
    [Google Scholar]
  12. Lee IR, Molton JS, Wyres KL, Gorrie C, Wong J et al. Differential host susceptibility and bacterial virulence factors driving Klebsiella liver abscess in an ethnically diverse population. Sci Rep 2016;6:29316 [CrossRef][PubMed]
    [Google Scholar]
  13. Zhang R, Lin D, Chan EW, Gu D, Chen GX et al. Emergence of carbapenem-resistant serotype K1 hypervirulent Klebsiella pneumoniae strains in China. Antimicrob Agents Chemother 2016;60:709–711 [CrossRef][PubMed]
    [Google Scholar]
  14. Chew KL, Lin RTP, Teo JWP. Klebsiella pneumoniae in Singapore: hypervirulent infections and the carbapenemase threat. Front Cell Infect Microbiol 2017;7:515 [CrossRef][PubMed]
    [Google Scholar]
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