The Journal of Association of Chest Physicians

CHEST IMAGE
Year
: 2017  |  Volume : 5  |  Issue : 2  |  Page : 89--90

Klebsiella pneumoniae liver abscess with metastatic spread to lung


Mansoor C Abdulla 
 Department of General Medicine, M.E.S. Medical College, Perinthalmanna, Kerala, India

Correspondence Address:
Mansoor C Abdulla
Department of General Medicine, M.E.S. Medical college, Perinthalmanna, Kerala - 679 338
India




How to cite this article:
Abdulla MC. Klebsiella pneumoniae liver abscess with metastatic spread to lung.J Assoc Chest Physicians 2017;5:89-90


How to cite this URL:
Abdulla MC. Klebsiella pneumoniae liver abscess with metastatic spread to lung. J Assoc Chest Physicians [serial online] 2017 [cited 2020 Oct 25 ];5:89-90
Available from: https://www.jacpjournal.org/text.asp?2017/5/2/89/202901


Full Text

A 45-year-old male was admitted with high-grade fever and nonbilious vomiting for 8 days. He had type 2 diabetes mellitus since 10 years. Examination showed icterus and mild tender hepatomegaly. Investigations showed neutrophilic leucocytosis, high fasting plasma glucose level, and deranged liver function tests. Chest radiograph was normal. Computed tomographic scan with contrast of the abdomen and thorax showed focal lesion in segments VI and VII of the right lobe liver and multiple nodules in both lungs with heterogeneous enhancement [Figure 1]. Cultures of blood and aspirates from liver grew Klebsiella pneumoniae. The patient was treated with antibiotics (piperacillin, tazobactam, and ciprofloxacin) and continuous drainage of liver abscess with which he improved.{Figure 1}

Highly virulent strains of Klebsiella pneumoniae had emerged as a predominant cause of liver abscess in Asian countries.[1] Klebsiella liver abscess was also associated with a higher likelihood of hematogenous spread and the potential for metastatic infection in other parts of the body. Eyes, meninges, central nervous system (CNS), and lungs are the most common metastatic sites.[2] The incidence rate of metastatic infection ranges from 10 to 45%, especially in patients with diabetes mellitus. The mortality rate of patients with metastatic infections is significantly higher than that without metastatic infections (16–17% versus 0–1.1%) in various studies.

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Conflicts of interest

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References

1Chan DS, Archuleta S, Llorin RM, Lye DC, Fisher D. Standardized outpatient management of Klebsiella pneumonia liver abscesses. Int J Infect Dis 2013;17:e185-8.
2Sobirk SK, Struve C, Jacobsson SG. Primary Klebsiella pneumoniae liver abscess with metastatic spread to lung and eye, a North-European case report of an emerging syndrome. Open Microbiol J 2010;4:5-7.