[A case of liver abscess with meningitis and endophthalmitis: invasive liver abscess syndrome]

Nihon Shokakibyo Gakkai Zasshi. 2024;121(3):237-244. doi: 10.11405/nisshoshi.121.237.
[Article in Japanese]

Abstract

A woman in her 70s was hospitalized and was diagnosed with liver abscess and managed with antibiotics in a previous hospital. However, she experienced altered consciousness and neck stiffness during treatment. She was then referred to our hospital. On investigation, we found that she had meningitis and right endophthalmitis concurrent with a liver abscess. Klebsiella pneumoniae was detected from both cultures of the liver abscess and effusion from the cornea. A string test showed a positive result. Therefore, she was diagnosed with invasive liver abscess syndrome. Although she recovered from the liver abscess and meningitis through empiric antibiotic treatment, her right eye required ophthalmectomy. In cases where a liver abscess presents with extrahepatic complications, such as meningitis and endophthalmitis, the possibility of invasive liver abscess syndrome should be considered, which is caused by a hypervirulent K. pneumoniae.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Endophthalmitis* / complications
  • Endophthalmitis* / etiology
  • Female
  • Humans
  • Klebsiella Infections* / complications
  • Klebsiella Infections* / diagnosis
  • Klebsiella Infections* / drug therapy
  • Klebsiella pneumoniae
  • Liver Abscess* / diagnostic imaging
  • Liver Abscess* / etiology
  • Meningitis* / complications
  • Meningitis* / drug therapy

Substances

  • Anti-Bacterial Agents