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Antibiotic-resistant hypervirulent Klebsiella pneumoniae causing community- acquired liver abscess: an emerging
S Rodriguez-Villar1, A Fife2, C Baldwin1
1Critical Care Department, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Abstract:
We report a case of a patient with fatal community-acquired pyogenic liver abscess (CA-PLA) caused by multi drug-resistant, hypervirulent, Klebsiella pneumoniae (mdrhvKP). HvKP causing PLA has been described in East and South East Asia and it is recognized as an emerging infection worldwide. The syndrome is characterized by cryptogenic liver abscess formation without a previous history of hepatobiliary or colonic disease and metastatic spread of infection via the bloodstream to distant sites, including lungs, central nervous system and other organ systems. Diabetes mellitus is a recognized risk factor. Most previously reported cases have involved antibiotic susceptible strains of hvKP although reports of bloodstream infections caused by resistant strains, including carbapenemase producers, are increasing. Our report highlights the need for awareness of this devastating infection in patients presenting with sepsis and liver abscess without underlying hepatobiliary or colonic disease.
Insights
A fatal case of community-acquired pyogenic liver abscess was caused by multidrug-resistant, hypervirulent Klebsiella pneumoniae. This emerging infection can spread to multiple organs and requires increased clinical awareness.
Area of Science:
- Infectious Diseases
- Microbiology
- Hepatology
Background:
- Community-acquired pyogenic liver abscess (CA-PLA) is increasingly associated with hypervirulent Klebsiella pneumoniae (hvKP).
- hvKP infections, particularly multidrug-resistant strains (mdrhvKP), are an emerging global health concern.
- hvKP-associated PLA often presents cryptogenically with metastatic complications, unlike typical pyogenic liver abscesses.
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