Protean neuroimaging presentations in an adult with Klebsiella pneumoniae infection.
OBJECTIVE
To report on the findings of a series of cranial computed tomography (CT) and magnetic resonance (MR) imaging studies of a 57-years-old woman with Klebsiella (K.) pneumoniae infection.


METHODS
The patient had fever, consciousness disturbance and left hemiplegia as the initial presentations of K. pneumoniae infection. Initial blood culture grew K. pneumoniae, and a delayed purulent cerebrospinal fluid profile was found later. The serial neuroimaging studies showed cerebral hemorrhage, cerebritis and subsequent multiple abscess formations. In the meanwhile hepatic and pulmonary abscess were also discovered by imaging studies. With a 77- days intravenous ceftriaxone treatment (4 gm/day), the abscess formations of brain, lung and liver were all resolved.


CONCLUSIONS
This study showed the protean neuroimage features of a woman with K. pneumoniae infection and the confirmation of multiple brain abscesses was made by follow-up neuroimaging studies. These sequential neuroimage findings in one patient are uncommon but deserved special clinical note by the first-line, primary-care physicians including neurologists.
Lin
Chih-Hsiang
CH
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Lu
Chen-Hsien
CH
Lui
Chun-Chung
CC
Huang
Chi-Ren
CR
Chuang
Yao-Chung
YC
Chang
Wen-Neng
WN
D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007710:Klebsiella Infections / Q000175:diagnosis*; D007711:Klebsiella pneumoniae / Q000472:pathogenicity*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods