title: A case of hypermucoviscous Klebsiella pneumoniae liver abscess syndrome in an Iraqi male.
abstract: A 53-year-old man presented with fevers, productive cough and decreased appetite. He emigrated from Iraq 4 years ago. Chest x-ray revealed a left lung consolidation. Respiratory cultures and two sets of blood cultures grew out pan-susceptible Klebsiella pneumoniae Liver ultrasound revealed a 6.4-cm complex lesion in the left hepatic lobe. A biopsy of the liver lesion produced bloody purulent aspirate; abscess cultures yielded a highly viscous pan-susceptible K. pneumoniae Klebsiella pneumoniae liver abscess syndrome is a newly described invasive syndrome due to a hypermucoviscous phenotype associated with serotypes K1 and K2 of Klebsiella. Although it is more commonly endemic to the Asian-Pacific region, it has been increasingly reported as an emerging global disease. We present the first case of this syndrome in a patient of middle-eastern descent. We also present pictorial evidence of the microbe's unique viscous, muculent texture grown on agar.
authors.affiliation: From the Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA Address correspondence to Noora Kazanji, Department of Internal Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA. email: noora.kazanji@beaumont.org.
authors.forename: Noora
authors.initials: N
authors.lastname: Kazanji
authors.affiliation: From the Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA Address correspondence to Noora Kazanji, Department of Internal Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA. email: noora.kazanji@beaumont.org.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Klein
authors.affiliation: From the Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA Address correspondence to Noora Kazanji, Department of Internal Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA. email: noora.kazanji@beaumont.org.
authors.forename: Sadichhya
authors.initials: S
authors.lastname: Lohani
authors.affiliation: From the Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA Address correspondence to Noora Kazanji, Department of Internal Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA. email: noora.kazanji@beaumont.org.
authors.forename: Amy N
authors.initials: AN
authors.lastname: Mertens
authors.affiliation: From the Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA Address correspondence to Noora Kazanji, Department of Internal Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA. email: noora.kazanji@beaumont.org.
authors.forename: Julie
authors.initials: J
authors.lastname: Le
mesh_terms: D061605:Administration, Intravenous; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D021821:Communicable Diseases, Emerging / Q000382:microbiology*; D019299:Decompression, Surgical; D004322:Drainage; D000077727:Ertapenem; D006801:Humans; D007493:Iraq; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000472:pathogenicity*; D008100:Liver Abscess / Q000382:microbiology* / Q000628:therapy; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013577:Syndrome; D016896:Treatment Outcome; D047090:beta-Lactams / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000077727:Ertapenem