Emphysematous Liver Abscess and Disseminated Hypervirulent Klebsiella pneumoniae Infection in a Patient from Southern India
Amiya R Nayak, Ramu Ramadoss, Venkateswaran Ramanathan, Niveditha K Honnarudraiah
Brain abscess, India, Klebsiella, Liver abscess
Citation Information :
Nayak AR, Ramadoss R, Ramanathan V, Honnarudraiah NK. Emphysematous Liver Abscess and Disseminated Hypervirulent Klebsiella pneumoniae Infection in a Patient from Southern India. Indian J Crit Care Med 2022; 26 (3):381-383.
The pyogenic liver abscess is usually polymicrobial and is seen as a complication of biliary disease or peritonitis. Over the past three decades, monomicrobial liver abscess caused by Klebsiella pneumoniae is being increasingly reported from South East Asian countries like Taiwan and Korea. It is a community-acquired infection caused by a distinct strain, hypervirulent K. pneumoniae, different from classical strain related to the healthcare-associated Klebsiella infections. Diabetes mellitus is a significant risk factor. Reports of the disseminated infection due to hypervirulent Klebsiella are very few in Indian literature. We report the successful management of a diabetic patient with emphysematous liver abscess, brain abscess, and meningitis caused by hypervirulent K. pneumoniae infection.
Shah MY, Vij AS, Shah F, Seth S, Pandit NA. Amoebic liver abscess with metastatic amoebic brain abscess: a case report. Ann Trop Med Public Health 2016;9(1):76–79. DOI: 10.4103/1755-6783.174724.
Kinsley JD, Nisheeth TP, Francis G, Srinivas CN. Aberrant form of Klebsiella pneumoniae in fulminant emphysematous hepatitis with polymicrobial infection. Era's Journal of Medical Research 2017;4(1):35–37. DOI: 10.24041/ejmr2017.6.
Serraino C, Elia C, Bracco C, Rinaldi G, Pomero F, Silvestri A, et al. Characteristics and management of pyogenic liver abscess: a European experience. Medicine (Baltimore) 2018;97(19):e0628. DOI: 10.1097/MD.0000000000010628.
Ghosh S, Sharma S, Gadpayle AK, Gupta HK, Mahajan RK, Sahoo R, et al. Clinical, laboratory, and management profile in patients of liver abscess from northern India. J Trop Med 2014;2014:142382. DOI: 10.1155/2014/142382.
Kumar SK, Perween N, Omar BJ, Kothari A, Satsangi AT, Jha MK, et al. Pyogenic liver abscess: clinical features and microbiological profiles in tertiary care center. J Family Med Prim Care 2020;9(8):4337–4342. DOI: 10.4103/jfmpc.jfmpc_927_20.
Liu Y, Wang JY, Jiang W. An increasing prominent disease of Kebsiella pneumoniae liver abscess: etiology, diagnosis, and treatment. Gastroenterol Res Pract 2013;2013:258514. DOI: 10.1155/2013/258514.
Lee HL, Lee HC, Guo HR, Ko WC, Chen KW. Clinical significance and mechanism of gas formation of pyogenic liver abscess due to Klebsiella pneumoniae. J Clin Microbiol 2004;42(6):2783–2785. DOI: 10.1128/JCM.42.6.2783-2785.2004.
Chou FF, Sheen-Chen SM, Chen YS, Lee TY. The comparison of clinical course and results of treatment between gas-forming and non-gas forming pyogenic liver abscess. Arch Surg 1995;130(4):401–405. DOI: 10.1001/archsurg.1995.01430040063012.
Takano Y, Hayashi M, Niiya F, Nakanishi T, Hanamura S, Asonuma K, et al. Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report. BMC Res Notes 2017;10(1):117. DOI: 10.1186/s13104-017-2445-8.
Heneghan HM, Healy NA, Martin ST, Ryan RS, Nolan N, Traynor O, et al. Modern management of pyogenic hepatic abscess: a case series and review of the literature. BMC Res Notes 2011;4:80. DOI: 10.1186/1756-0500-4-80.
Doud MS, Grimes-Zeppegno R, Molina E, Miller N, Balachandar D, Schneper L, et al. A k2A-positive Klebsiella pneumoniae causes liver and brain abscess in a Saint Kitt's man. Int J Med Sci 2009;6(6): 301–304. DOI: 10.7150/ijms.6.301.