[Post-Traumatic Hypervirulent Klebsiella pneumoniae Infection: A Rare Case Presenting with Liver Abscess and...

Hypervirulent Klebsiella pneumoniae (hvKp) is a pathotype characterized by high virulence capacity and rapid dissemination, which has gained increasing importance in recent years. It can cause invasive infections with multi-organ involvement, such as liver abscess, necrotizing fasciitis, meningitis and endophthalmitis and represents a significant public health threat due to its high mortality rates. Although numerous studies have investigated its risk factors, trauma-associated cases are extremely rare and different hypotheses have been proposed regarding their pathophysiology. The most widely accepted mechanism suggests that trauma disrupts immune barriers, facilitating pathogen entry and promoting the development of invasive infections. In this report, a case of a 71-year-old male patient with a history of diabetes mellitus who developed a liver abscess and endogenous endophthalmitis following trauma was presented. Blood, vitreous and abscess specimen cultures yielded non-extended-spectrum beta-lactamase-producing K.pneumoniae isolatessusceptible to third-generation cephalosporins, which exhibited hypermucoviscous phenotype. Polymerase chain reaction analysis demonstrated that these isolates belonged to the K1 capsular type and harbored the aerobactin gene. Despite intravenous and intravitreal therapy, high fever persisted. Ultrasonographic examination of the abdomen revealed a hepatic abscess in the right lobe and percutaneous drainage was subsequently performed. Although clinical improvement was achieved, the patient developed persistent partial vision loss. In conclusion, trauma may serve as a portal of entry for hvKp infections and severe cases with multifocal involvement can lead to permanent complications despite early and appropriate treatment. Rapid diagnosis of hypervirulent infections and early investigation of potential metastatic foci are critical for reducing morbidity and mortality.