Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome.
BACKGROUND
Klebsiella pneumoniae-associated liver abscesses have distinct clinical and epidemiologic features.


METHODS
We report the unusual case of an American patient with a K. pneumoniae-associated liver abscess and septic spread to other organs. We additionally present a comprehensive review of K. pneumoniae-associated liver abscess syndromes in adults.


RESULTS
We identified three distinct K. pneumoniae liver abscess syndromes: the polymicrobial liver abscess, the monomicrobial cryptogenic noninvasive liver abscess, and the monomicrobial cryptogenic invasive K. pneumoniae-associated liver abscess (CIKPLA) syndromes, with distinct clinical, epidemiologic and outcome features. CIKPLA syndrome typically affects diabetic patients, mainly in Southeast Asia, and is complicated by septic spread to other organs.


CONCLUSIONS
The community-acquired, monomicrobial, K. pneumoniae-associated liver abscess syndromes that typically occur in the USA are mainly noninvasive and affect Asian or Hispanic persons. However, this report provides an alert that CIKPLA syndrome can occur in North America, and physicians need to be aware of it.
Phase I Program, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 422, Houston, TX 77030-4009, USA. fbraiteh@mdanderson.org
Fadi
F
Braiteh
Marjorie P
MP
Golden
D000328:Adult; D016470:Bacteremia / Q000382:microbiology / Q000473:pathology; D006801:Humans; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008100:Liver Abscess / Q000382:microbiology* / Q000473:pathology; D008297:Male; D016920:Meningitis, Bacterial / Q000382:microbiology / Q000473:pathology