Simultaneous Klebsiella pneumoniae and amoebic liver abscess in an immunocompetent patient.
Simultaneous Klebsiella pneumoniae and amoebic liver abscess is rarely reported in immunocompetent patients. A 47-year-old man was hospitalized with abdominal pain, fever, chills, and hypotension. Physical examination revealed right upper quadrant tenderness. Abdominal computed tomography showed an area of low attenuation with some liquefaction in the liver. Echo-guided aspiration revealed 30 mL of pus, which grew Klebsiella pneumoniae, and the same organism was isolated from the blood. Cytology examination of the pus showed scattered amoeba. The patient gradually improved over 1 month on treatment with cefmetazole and metronidazole, along with repeated drainage of the abscess. His amoebic indirect hemagglutination titer was 1:128, but no parasite ova or amoeba were found in the stool. He had no evidence of immunocompromise. Parasitic diseases may be a predisposing factor for bacterial infections, including pyogenic liver abscess. The possible coexistence of amoebae and bacteria in a liver abscess should not be discounted.
Chen
Huan-Lin
HL
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
Chang
Wen-Hsiung
WH
Shih
Shou-Chuan
SC
Lin
Shee-Chan
SC
Wang
Tsang-En
TE
Chu
Cheng-Hsin
CH
Chen
Yu-Jan
YJ
Pang
Kwok-Kuen
KK
Bair
Ming-Jong
MJ
D006801:Humans; D007710:Klebsiella Infections / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D007711:Klebsiella pneumoniae; D008101:Liver Abscess, Amebic / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged