Vasculitic Rash: A Rare Complication of Klebsiella Liver Abscess in Uncontrolled Diabetes

Klebsiella pneumoniae liver abscess (KPLA) is a known complication in patients with poorly controlled diabetes mellitus, frequently resulting in bacteremia and metastatic infections. However, cutaneous manifestations, such as vasculitic rash, are exceedingly rare. We present a case of a 45-year-old male with uncontrolled diabetes who was admitted with high-grade fever, rigors, and dyspnea. Within 24 h of admission, he developed a bilateral, purpuric, non-blanching rash on the lower limbs suggestive of vasculitis. Laboratory investigations revealed a negative vasculitis screen and positive blood cultures for Klebsiella pneumoniae (K. pneumoniae). Computed tomography of the abdomen identified a large subcapsular liver abscess. The patient was successfully treated with percutaneous radiologically guided drainage and broad-spectrum antibiotics. This case highlights that clinicians should consider infectious etiologies, such as K. pneumoniae in vasculitic rashes among diabetic patients, as misdiagnosis and inappropriate immunosuppression can worsen outcomes.