Cerebral venous sinus thrombosis in a patient with Klebsiella pneumoniae primary liver abscess: a case report

BMC Neurol. 2022 Jul 30;22(1):286. doi: 10.1186/s12883-022-02806-y.

Abstract

Background: Liver abscess is a common emergency in the emergency department. However, cerebral venous sinus thrombosis (CVST) is a rare and serious cerebrovascular disease. Cases of CVST in patients with Klebsiella pneumoniae primary liver abscess (KLA) have not been described in the literature. We report a case of CVST in patients with KLA.

Case presentation: A 54-year-old male patient came to our department with a fever for 2 days and altered mental status for 1 day. Abdominal computed tomography (CT) and liver magnetic resonance imaging (MRI) revealed multiple liver abscesses. The blood culture was identified as Klebsiella pneumoniae sepsis. Head contrast-enhanced MRI and magnetic resonance venography (MRV) imaging showed multiple thrombus formation in the right transverse sinus and sigmoid sinus. The patient's infection and thrombosis were controlled within one week of multidisciplinary comprehensive treatment such as antibiotic and antithrombotic therapy, and a good clinical recovery during the 1-month follow-up.

Conclusion: CVST after liver abscess is rare, clinicians should be aware of this complication and vigilant for the possibility of bacterial meningitis. The underlying mechanisms need to be further studied.

Keywords: Case report; Cerebral venous sinus thrombosis; Liver abscess.

Publication types

  • Case Reports

MeSH terms

  • Cranial Sinuses
  • Humans
  • Klebsiella pneumoniae
  • Liver Abscess* / complications
  • Liver Abscess* / diagnostic imaging
  • Male
  • Middle Aged
  • Phlebography / methods
  • Sinus Thrombosis, Intracranial* / complications
  • Sinus Thrombosis, Intracranial* / diagnostic imaging