Keeping an Eye Out for Klebsiella Endopthalmitis: Klebsiella Pneumoniae Invasive Liver Abscess Syndrome

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.

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Liver Abscess Caused by magA+ Klebsiella pneumoniae in North America

Journal of Clinical Microbiology ◽

10.1128/jcm.43.2.991-992.2005 ◽

2005 ◽

Vol 43 (2) ◽

pp. 991-992 ◽

Cited By ~ 70

Author(s):

F. C. Fang ◽

N. Sandler ◽

S. J. Libby

Keyword(s):

North America ◽

Klebsiella Pneumoniae ◽

Liver Abscess

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Genotypes and virulence in serotype K2 Klebsiella pneumoniae from liver abscess and non-infectious carriers in Hong Kong, Singapore and Taiwan

Gut Pathogens ◽

10.1186/1757-4749-6-21 ◽

2014 ◽

Vol 6 (1) ◽

pp. 21 ◽

Cited By ~ 56

Author(s):

Jung-Chung Lin ◽

Tse Koh ◽

Nelson Lee ◽

Chang-Phone Fung ◽

Feng-Yee Chang ◽

...

Keyword(s):

Hong Kong ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Serotype K2

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Severe invasive disease caused by hypervirulent Klebsiella pneumoniae: a case report

10.22514/sv.2021.052 ◽

2021 ◽

Keyword(s):

Klebsiella Pneumoniae ◽

Patient Outcomes ◽

Liver Abscess ◽

Pathogenic Bacteria ◽

Treatment Options ◽

Invasive Disease ◽

Multiple Organ ◽

Multiple Organ Dysfunction ◽

Antimicrobial Drugs ◽

Life Threatening

Klebsiella pneumoniae (K. pneumoniae) is a common pathogenic bacteria that causes numerous infectious diseases. Hypervirulent K. pneumoniae (hvKP) can lead to invasive K. pneumoniae liver abscess syndrome, which can induce life-threatening multiple organ dysfunction syndrome or septic shock. We report a case of invasive K. pneumoniae liver abscess syndrome caused by hvKP and discuss the treatment options of this syndrome. Appropriate antimicrobial drugs should be administered to improve prognosis and prevent complications, and laboratory testing is essential to guide clinical management and optimize patient outcomes.

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Klebsiella pneumoniae Liver Abscess Complicated With Septic Pulmonary Embolism

Journal of the Korean Geriatrics Society ◽

10.4235/jkgs.2013.17.4.239 ◽

2013 ◽

Vol 17 (4) ◽

pp. 239-243

Author(s):

Jae Ryung Yi ◽

Yeop Yoon ◽

Yu Na Jung ◽

Hee Sook Lee ◽

Gi Ho Jo ◽

...

Keyword(s):

Pulmonary Embolism ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Septic Pulmonary Embolism

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Klebsiella pneumoniae liver abscess complicated by endogenous endophthalmitis: the importance of early diagnosis and intervention

The Medical Journal of Australia ◽

10.5694/mja15.00107 ◽

2015 ◽

Vol 203 (7) ◽

pp. 300-301 ◽

Cited By ~ 1

Author(s):

Phoebe P Moore ◽

Gerard F McGowan ◽

Sukhpal S Sandhu ◽

Penelope J Allen

Keyword(s):

Early Diagnosis ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Endogenous Endophthalmitis

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The first case of Klebsiella pneumoniae liver abscess with hemophagocytic lymphohistiocytosis

Journal of Microbiology Immunology and Infection ◽

10.1016/j.jmii.2018.10.012 ◽

2019 ◽

Vol 52 (2) ◽

pp. 363-364

Author(s):

Ying-Ting Liao ◽

Po-Shen Ko ◽

Yi-Tsung Lin

Keyword(s):

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Hemophagocytic Lymphohistiocytosis ◽

First Case

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TREM-1 Promotes Survival during Klebsiella pneumoniae Liver Abscess in Mice

Infection and Immunity ◽

10.1128/iai.01347-13 ◽

2014 ◽

Vol 82 (3) ◽

pp. 1335-1342 ◽

Cited By ~ 15

Author(s):

Yi-Tsung Lin ◽

Kai-Yu Tseng ◽

Yi-Chen Yeh ◽

Fu-Chen Yang ◽

Chang-Phone Fung ◽

...

Keyword(s):

Small Intestine ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Survival Rates ◽

Bacterial Clearance ◽

Mesenteric Lymph Nodes ◽

Content Type ◽

Cytokine Levels ◽

Peptide Expression ◽

Antimicrobial Peptide Expression

ABSTRACTKlebsiella pneumoniaeliver abscess (KPLA) is prevalent in East Asia. Liver abscess can develop after translocation ofK. pneumoniaefrom a patient's bowel into the liver via the portal circulation. TREM-1 (triggeringreceptorexpressed onmyeloid cells1) amplifies inflammatory signaling during infection, but its role in KPLA is poorly understood. We used an animal study to characterize the role of TREM-1 in KPLA. We compared survival rates, bacterial burdens in tissues, inflammatory cytokine levels, and histology findings between wild-type andTrem-1knockout (KO) mice after oral inoculation of capsular type K1K. pneumoniae. Translocation ofK. pneumoniaeto mesenteric lymph nodes and liver was examined, and intestinal permeability, antimicrobial peptide expression, and the clearance ofK. pneumoniaein the small intestine were determined. In the absence of TREM-1, KPLA model mice showed increasedK. pneumoniaedissemination, enhanced liver and systemic inflammation, and reduced survival. Impaired bacterial clearance in the small intestine causes enhancedK. pneumoniaetranslocation, which rendersTrem-1KO mice more susceptible toK. pneumoniaeoral infection. In conclusion, TREM-1-mediated bacterial clearance in the small intestine is an important immune response againstK. pneumoniae. TREM-1 deficiency enhancesK. pneumoniaetranslocation in the small intestine and increases mortality rates in mice with KPLA.

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