New emerging liver infection
71 yoM , resident of the US with recent trip to Cape Verde, is brought in directly from the airport for complaints of early satiety, weight loss and abdominal distension which started prior to his leaving. He was found to have large multi-loculated invasive abscesses in the left and caudate lobes of his liver which grew Klebsiella pneum.
Teaching points:
– Klebsiella invasive liver abscess is a new emerging infection described in Taiwan and S. Africa but now also seen in other parts of the world (as in our patient).
– Klebsiella causes mostly a primary liver infection and has been associated with metastatic infections like endophthalmititis, meningitis, brain abscess, discitis etc and so watch out for these!
– if multi-loculated, consider meticulous IR guided drainage with perc drain or surgical breakdown of septations to be able to access all the pus pockets adequately.
Links to some reference articles: