An Increasing Prominent Disease ofKlebsiella pneumoniaeLiver Abscess: Etiology, Diagnosis, and Treatment

Abstract

Background. During the past two decades, Klebsiella pneumoniae (K. pneumoniae) had surpassed Escherichia coli (E. coli) as the predominant isolate from patients with pyogenic liver abscess (PLA) in Asian countries, the United States, and Europe, and it tended to spread globally. Since the clinical symptom is atypical, the accurate and effective diagnosis and treatment of K. pneumoniae liver abscesses (KLAs) are very necessary. Methods. Here, we have comprehensively clarified the epidemiology and pathogenesis of KLA, put emphases on the clinical presentations especially the characteristic radiographic findings of KLA, and thoroughly elucidated the most effective antibiotic strategy of KLA. Results. K1 serotype is strongly associated with KLA especially in diabetic patients. Computed tomography (CT) and ultrasound (US) were two main diagnostic methods of KLA in the past. Most of KLAs have solitary, septal lobular abscesses in the right lobe of liver, and they are mainly monomicrobial. Broad-spectrum antibiotics combined with the US-guided percutaneous drainage of liver abscesses can increase their survival rates, but surgical intervention still has its irreplaceable position. Conclusion. The imaging features contribute to the early diagnosis, and the percutaneous intervention combined with an aminoglycoside plus either an extended-spectrum betalactam or a second- or third-generation cephalosporin is a timely and effective treatment of KLA.

Analysis of the Bacterial Diversity in Liver Abscess: Differences Between Pyogenic and Amebic Abscesses

“…KC692181), which has been associated with human infections in some liver abscesses. 37,38 The phylogenetic reconstruction separated Bacteroides and Bacteroidetes into two clades ( Figure 2B). The two variants from Bacteroides were detected in the same patient with a pyogenic abscess (N138; clade 1), whereas Bacteroidetes was represented in two groups in the pyogenic abscesses of patients N140 and N117 (clade 2).…”

“…30,38 Such tools would allow the reliable identification of the most prevalent etiologic agents in endemic areas of gastrointestinal infectious diseases. Mexico is one such endemic area, and the most vulnerable population is children younger than 15 years of age.…”

Pyogenic Liver Abscess after Bile Duct Exploration Drained with Endoscopic Techniques

“…The bacteria culture and the bacteria sensitivity test allow the appropriate choice of antibiotics. The duration of antibiotic should persist for 2 ~ 6 weeks [8]. Surgical drainage is not essential for most of the patients with PLA, but required, especially when the abscess is larger than 3 ~ 5 cm in diameter and the antibiotic therapy fails [9].…”

Invasive Liver Abscess Syndrome Caused by Klebsiella pneumoniae and Metastatic Infection Causing Vision Loss: A Case Report

“…K. pneumoniae'ye bağlı primer karaciğer apsesi sendromunun seyrinde metastatik infeksiyon olarak endoftalmi gelişen hastalarda genellikle görme kaybı söz konusudur (15). Erken tanısı için USG ve BT incelemesi yararlıyken tedavisinde parenteral geniş spektrumlu antibiyotik ve perkütan drenaj etkilidir (23). Olgumuzda karaciğer apsesinin karaciğerin arka segmentinde olması nedeniyle USG'de görü-lemediği halde BT incelemesinde multiloküle apse olarak saptandı.…”