Klebsiella pneumoniae invasive liver abscess syndrome with purulent meningitis and septic shock: A case from mainland China

World J Gastroenterol. 2016 Mar 7;22(9):2861-6. doi: 10.3748/wjg.v22.i9.2861.

Abstract

We present a rare case of invasive liver abscess syndrome due to Klebsiella pneumoniae (K. pneumoniae) with metastatic meningitis and septic shock. A previously healthy, 55-year-old female patient developed fever, liver abscess, septic shock, purulent meningitis and metastatic hydrocephalus. Upon admission, the clinical manifestations, laboratory and imaging examinations were compatible with a diagnosis of K. pneumoniae primary liver abscess. Her distal metastasis infection involved meningitis and hydrocephalus, which could flare abruptly and be life threatening. Even with early adequate drainage and antibiotic therapy, the patient's condition deteriorated and she ultimately died. To the best of our knowledge, this is the first case of K. pneumoniae invasive liver abscess syndrome with septic meningitis reported in mainland China. Our findings reflect the need for a better understanding of the epidemiology, risk factors, complications, comorbid medical conditions and treatment of this disease.

Keywords: Invasive liver abscess syndrome; Klebsiella pneumonia; Meningitis; Pyogenic liver abscess; Septic shock.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteriological Techniques
  • China
  • Disease Progression
  • Drainage
  • Fatal Outcome
  • Female
  • Humans
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / microbiology*
  • Klebsiella Infections / therapy
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / isolation & purification
  • Klebsiella pneumoniae / pathogenicity*
  • Liver Abscess / diagnosis
  • Liver Abscess / microbiology*
  • Liver Abscess / therapy
  • Meningitis, Bacterial / diagnosis
  • Meningitis, Bacterial / microbiology*
  • Meningitis, Bacterial / therapy
  • Middle Aged
  • Shock, Septic / diagnosis
  • Shock, Septic / microbiology*
  • Shock, Septic / therapy
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents