Norovirus gastroenteritis complicated by polymicrobial bacteremia and liver abscess

This report describes a patient with norovirus gastroenteritis complicated by a polymicrobial liver abscess involving Klebsiella pneumoniae and Clostridium perfringens. The patient presented with viral gastroenteritis and subsequently developed bacteremia and multiple hepatic abscesses within six days, likely due to norovirus-associated disruption of the intestinal mucosa facilitating bacterial translocation. Blood cultures identified both bacterial organisms, and stool polymerase chain reaction (PCR) detected norovirus. Despite the high mortality associated with C. perfringens bacteremia, including the risk of fulminant intravascular hemolysis, early recognition and prompt antibiotics led to the patient's full recovery. This case underscores the potential for severe bacterial superinfection after norovirus gastroenteritis and highlights the importance of closely monitoring for systemic symptoms. Timely diagnosis and treatment can significantly improve outcomes, even in infections that can otherwise be rapidly fatal.