Pyogenic Liver Abscess with a Focus on Klebsiella pneumoniae as a Primary Pathogen: An Emerging Disease with Unique Clinical Characteristics

Lederman, Edith; Crum, Nancy F.

doi:10.1111/j.1572-0241.2005.40310.x

Cited by 349 publications

(317 citation statements)

References 42 publications

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“…The results contrast with numerous series that reported progressive increase of K. pneumoniae over E. coli as primary pathogen causing PLA, especially in patients with diabetes mellitus. 1,5,[12][13][14][15][16][17] The isolation of MDRB was slightly higher as compared to other reports 17 and could be explained by the notable presence of patients with chronic disease and history of prolonged hospitalizations. A 75% of MDRB were isolated in transplant recipients or patients with NBIPLA with active oncologic disease.…”

Section: Discussionmentioning

confidence: 63%

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Czerwonko

Huespe

Bertone

et al. 2016

HPB

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Section: Discussionmentioning

confidence: 63%

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Czerwonko

Huespe

Bertone

et al. 2016

HPB

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“…[1][2][3][4] Its emergence in western countries has also been reported. [5][6][7] Previous studies in Taiwan, Singapore and Korea found a high prevalence of the capsular polysaccharide (CPS) K antigen serotypes K1 (54.5-63.4%) and K2 (5-21.2%) of K. pneumoniae in liver abscess isolates. 1,[8][9][10] Apart from the capsular serotypes, other virulence determinants have also been reported for K. pneumoniae liver abscesses, including the presence of hypermucoviscosity, aerobactin, magA (mucoviscosity-associated gene A), rmpA (regulator of mucoid phenotype), kfu (responsible for an iron uptake system) and allS (associated with allantoin metabolism) genes.…”

mentioning

confidence: 99%

Immune response and pathophysiological features of Klebsiella pneumoniae liver abscesses in an animal model

Fung

Chang

Lin

et al. 2011

Laboratory Investigation

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Capsular serotypes K1 and K2, the rmpA gene (a regulator of the mucoid phenotype) and aerobactin from Klebsiella pneumoniae have been identified as the major virulence factors for pyogenic liver abscesses with high morbidity, mortality and severe complications. The pathological mechanisms remain unclear. In this study, we compared liver immune responses and pathological changes in response to different serotypes of K. pneumoniae infections. A mouse model was used to investigate cytokine and chemokine production, histopathology findings, phagocytic uptake and mortality induced by serotypespneumoniae serotypes K1 and K2 showed lower 50% lethal dose values and more phagocytic resistance to neutrophils than K62 and the DK1 mutant. In sequential liver samples, viable bacteria counts increased 3 h to 3 days after low-dose inoculation (o10 1 colony-forming unit (cfu)) with K1 and K2, while K62 and DK1 cleared rapidly and became undetectable even with high-dose inoculation (B2.9 Â 10 5 cfu). Time-dependent increases in cytokines and chemokines, including tumor necrosis factor-a, interleukin (IL)-1b, IL-6, IL-10, keratinocyte-derived chemokines and macrophage inflammatory protein-2, were observed in the serum and liver tissue of K1-and K2-infected mice, and severe disease progression manifesting as microabscesses was also identified. K62 and DK1 inoculation did not result in similar immune responses and histological changes. These findings illustrate the critical role of phagocytic resistance against innate immunological defense mechanisms as well as its contribution to the development of liver abscesses.

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“…The incidence of K. pneumoniae infection increases in immunocompromised conditions, such as diabetes mellitus, alcoholism, malignancy, hepatobiliary disease, chronic obstructive pulmonary disease, glucocorticoid therapy and renal failure [6][7][8][9][10][11][12][13][14]. In our case, the In a few cases, K. pneumoniae liver abscess has been associated with metastatic infection at other sites [7,8,[10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 97%

Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

et al. 2011

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Emphysematous prostatitis combined with a liver ab scess caused by Klebsiella pneumoniae Emphysematous prostatitis is a rare condition that is characterized by gas and abscess accumulation in the prostate. This uncommon but serious disease requires special attention because of its nonspecific presentation such as dysuria, frequency, urgency, fever, acute urinary retension and/or perineal pain. We report here on a case of emphysematous prostatitis that was combined with a liver abscess caused by Klebsiella pneumoniae. A 55yearold man was admitted due to a 3day history of urinary retention with a febrile sensation. He had histories of liver cirrhosis and uncontrolled diabetes mellitus. After blood and urine cultures, levofloxacin 500 mg was started intravenously. On the third hospital day, he displayed septic shock.The kidneysureters bladder (KUB) Xray showed pockets of airaccumulation in the lower pelvic cavity, and abdominopelvic computed tomography (CT) with contrast enhancement taken on the third day showed a 5cm liver abscess with an emphysematous prostate. Intravenous antibiotics was changed to metronidazole 500 mg q.i.d. and cefotaxime 2 g t.i.d. On the sixth day, transurethral resection and drainage were performed under spinal anesthesia. However, the postoperative bleeding continued and hypovolemic shock persisted, which then provoked multiorgan failure. The patient died on the 11th hospital day. K. pneumoniae was cultured from the liver abscess aspirate, blood and prostatic tissue, and the bacteria were sensitive to both levofloxacin and cefotaxime. Emphysematous prostatitis is a difficult to diagnose because of its rarity and nonspecific symptoms. A delayed diagnosis can cause high mortality and morbidity, so making a prompt clinical diagnosis of this condition is essential. Appropriate antibiotics with early adequate incision and drainage are also needed.

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Pyogenic Liver Abscess with a Focus on Klebsiella pneumoniae as a Primary Pathogen: An Emerging Disease with Unique Clinical Characteristics

Cited by 349 publications

References 42 publications

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Immune response and pathophysiological features of Klebsiella pneumoniae liver abscesses in an animal model

Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

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