K2 serotype Klebsiella pneumoniae causing a liver abscess associated with infective endocarditis

Area of Science:

• Infectious Diseases
• Hepatology
• Microbiology

Background:

• Klebsiella pneumoniae primary liver abscess (KPLA) is an increasingly recognized clinical syndrome.
• KPLA is known to be associated with severe, distant septic complications.
• Infective endocarditis is a serious cardiac infection, typically caused by bacteria or fungi.

Observation:

• This study presents the first documented case of KPLA occurring concurrently with infective endocarditis.
• The causative Klebsiella pneumoniae isolate was identified as a hypermucoid K2 serotype.
• The isolate possessed the rmpA virulence-associated gene, known to contribute to mucoid phenotype and pathogenicity.

Findings:

• The co-occurrence of KPLA and infective endocarditis represents a novel and potentially severe clinical presentation.
• The presence of the rmpA gene in the hypermucoid K2 strain highlights its significant role in the pathogenesis of this complex infection.
• This case underscores the potential for K. pneumoniae to cause widespread systemic infection beyond the liver.

Implications:

• This case expands the spectrum of known complications associated with KPLA.
• It suggests the importance of considering cardiac involvement in patients presenting with severe KPLA, especially those with risk factors for endocarditis.
• Further research is warranted to understand the mechanisms linking KPLA and infective endocarditis and to guide clinical management.