Klebsiella (K.) pneumoniae infections, including adult bacterial meningitis (ABM), are a distinct syndrome in Taiwan, which may consist of diabetes mellitus and multiple septic metastatic lesions such as liver abscess, endophthalmitis, and focal suppuration of other internal organs. In this review article, the authors will discuss the protean clinical manifestations and the complexity of the clinical course of this specific central nervous system infectious disease in Taiwan. The clinical and laboratory data of 49 K. pneumoniae ABM cases diagnosed at Chang Gung Memorial Hospital-Kaohsiung, collected over a period of 11 years (2000-2010), were included for analysis. This review may help clinical physicians, especially first-line, primary- care physicians, to have a better understanding of this critical CNS infection.