scholarly journals Klebsiella pneumoniae cryptogenic liver abscess and endophthalmitis – a case report and review of literature

2021 ◽  
pp. 330-335
Author(s):  
Mihai Grecescu ◽  
Monica Grecescu ◽  
Andreea Smarandache ◽  
Cristian Branescu ◽  
Anca Anghelache ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Primary Infection ◽  
Hepatic Abscess ◽  
Etiologic Agent ◽  
Orbital Cellulitis ◽  
Review Of Literature ◽  
Severe Morbidity ◽  
Vitreous Sample ◽  
String Test

Klebsiella pneumoniae has emerged as the predominant pathogenic agent of liver abscess in Asia, and the incidence is increasing worldwide. Hypervirulent strains are associated with septic metastatic dissemination in the eyes, lungs, and central nervous system, causing severe morbidity. We present the case of a 54year old man, with no previous comorbidities, admitted in emergency for the blind red painful eye. Further investigation documented septic endophthalmitis with transscleral extension and orbital cellulitis. Thoraco-abdominal computed tomography evidenced a hepatic abscess as the locus of the primary infection. Intravenous antibiotherapy with cefuroxime, followed by meropenem and vancomycin were efficient for managing the hepatic abscess. However, as the eyeball was perforated at the admission, evisceration was performed. The vitreous sample revealed Klebsiella pneumoniae, with a positive string test as the etiologic agent. The diagnostic and therapeutic management required a permanent collaboration between an ophthalmologist, infectious diseases specialist, surgeon, and radiologist.

Clinical and Molecular Analysis of Klebsiella pneumoniae Causing Liver Abscess in China

2016 ◽  
Vol 26 (4) ◽  
pp. 245-251 ◽  
Author(s):  
Yunfang Sun ◽  
Hua Wu ◽  
Dingxia Shen
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multiplex Pcr ◽  
Liver Abscess ◽  
Chinese Patients ◽  
Molecular Characteristics ◽  
Beijing Area ◽  
Liver Abscesses ◽  
String Test ◽  
Almost All ◽  
New Criteria

<b><i>Objective:</i></b> Hypervirulent <i>Klebsiella pneumoniae</i> (hvKP) has been characterized as the major pathogen associated with the development of liver abscesses. Although the prevalence of <i>K. pneumoniae</i> in liver abscesses in Chinese patients is on the rise, methods for the early laboratory identification and recognition of hvKP are lacking, and hvKP detection and surveillance are thus limited. <b><i>Methods:</i></b> A retrospective study was conducted in 240 patients with cultures that were positive for <i>K. pneumoniae</i>, who were hospitalized in the Hospital of Beijing area from May 2013 to August 2014. The clinical and molecular characteristics of <i>K. pneumoniae</i> strains that cause liver abscesses were studied. Thirty-eight (16.7%) of 240 patients positive for <i>K. pneumoniae</i> cultures had liver abscesses. <b><i>Results:</i></b> Among these <i>K. pneumoniae</i> isolates, 92.1% (35/38) and 84.2% (32/38) were <i>rmpA </i>and <i>aerobactin (abc)</i> positive, respectively, as indicated by multiplex PCR, while 81.6% (31/38) were string test positive. Intriguingly, <i>K. pneumoniae</i> isolates that were positive for <i>rmpA, abc</i>, or string test accounted for almost all isolates (97.3%; n = 37/38) and thus were defined as hvKP in this study. Based on the new criteria for hvKP, none of these hvKP strains were positive for extended spectrum β-lactamases. <b><i>Conclusions:</i></b> Compared to the string test alone, integrating rmpA and abc detection with the string test is robuster and more extensive in the identification of liver abscess-causing hvKP strains. Multiplex PCR assays may therefore accelerate the early laboratory detection of hvKP.

scholarly journals Klebsiella Pneumoniae Liver Abscess: a Case Report and Review of Literature

Cureus ◽  
2017 ◽  
Author(s):  
Faisal Kamal ◽  
George Williams ◽  
Hina Akbar ◽  
Muhammad Ali Khan ◽  
Dipen Kadaria
Keyword(s):  
Case Report ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Review Of Literature

Endogenous Endophthalmitis Associated with Pyogenic Liver Abscess Caused by Klebsiella Pneumoniae: A Case Report

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Wael Ferjaoui ◽  
Mohamed Hajri ◽  
Souhail Karwiya ◽  
Seifeddine Baccouche ◽  
Sahir Omrani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Exceptional Case ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Percutaneous Transhepatic Drainage ◽  
Transhepatic Drainage

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

scholarly journals A case report of pyogenic liver abscess caused by hypervirulent Klebsiella pneumoniae diagnosed by metagenomic next-generation sequencing

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110327
Author(s):  
Jiafeng Xie ◽  
Zhiqiang Zhu
Keyword(s):  
Case Report ◽  
Next Generation Sequencing ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Next Generation ◽  
Drainage Fluid ◽  
String Test ◽  
History Of ◽  
Generation Sequencing

A 56-year-old woman with a history of diabetes mellitus presented with high fever but no abdominal pain. An abdominal computed tomography scan showed a large liver abscess. Hypervirulent, string test-positive, rmpA/ ampA2-, and iutA-positive Klebsiella pneumoniae was rapidly identified from drainage fluid of the liver abscess using metagenomic next-generation sequencing (mNGS). After intravenous antibiotic therapy and drainage of the abscess, the patient’s condition resolved. This case report highlights the value of mNGS in rapidly and accurately identifying a pathogenic microorganism, which helps reduce the incidence of antimicrobial resistance and enables the targeted use of antibiotics.

scholarly journals Virulence Characteristics and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2021 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Growth Curves ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Infection Model ◽  
Tertiary Teaching ◽  
String Test ◽  
Serum Killing

Abstract Background: To date, little is known about the virulence characteristics of pyogenic liver abscess (PLA) that cause multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae), and this might be due to that these strains are rare. This study aimed to analyze the virulence characteristics and molecular epidemiology of 12 MDR strains obtained from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes, and genotypes.Results: The results of growth curves, string test, capsular quantification, serum killing test, biofilm formation assay, and infection model revealed that the virulence phenotypes of the 12 PLA-causing MDR K. pneumoniae were similar or even more obvious than those of typical hypervirulent K. pneumoniae strains. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. The results of multilocus sequence typing (MLST) illustrated that the MDR strains were categorized into 9 sequence types.Conclusions: This study is the first to analyze the virulence characteristics in PLA-causing MDR strains. Our data exhibited the coexistence of hypervirulence and MDR in PLA-causing MDR K. pneumoniae strains, and the clones of those PLA-causing MDR strains were diverse and scattered. This study first found one ST11 carbapenem-resistant hypervirulent strain in PLA.

scholarly journals Characteristics of gas-forming pyogenic liver abscess caused by Klebsiella pneumoniae and Clostridi perfringens

2019 ◽  
Author(s):  
Zheng-Yang Chen ◽  
Nan Jiang ◽  
Song Guo ◽  
Bin-Bin Li ◽  
Jia-Qi Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Review Of Literature ◽  
Manual Search ◽  
Life Threatening ◽  
Low Incidence ◽  
Background Gas ◽  
Prevalence Of Diabetes Mellitus

Abstract Background: Gas-forming pyogenic liver abscess is a life-threatening disease with poor prognosis commonly caused by 2 bacteria, Klebsiella pneumoniae and Clostridium perfringens . Due to its low incidence and associated high mortality rate, it is important to study the biological characteristics of the disease. The aim of this study was to conduct a worldwide review of literature on gas-forming pyogenic liver abscess caused by K. pneumoniae and C. perfringens . Methods: We searched PubMed and Web of Science databases from January 2009 to March 2019, with published in English. All relevant articles were accessed in full text. The manual search included references of retrieved articles. Finally, 35 publications were selected for review. Results: The results showed that more cases of gas-forming pyogenic liver abscess in Asia were caused by K. pneumoniae than by C. perfringens (P=0.011). The prevalence of diabetes mellitus in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae was higher than caused by C. perfringens (P=0.032). The survival rate of patients with gas-forming pyogenic liver abscess caused by K. pneumoniae who received surgical debridement or drainage was higher than caused by C. perfringens (P=0.002). Conclusions: The prevalence of diabetes mellitus was higher in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae than in patients caused by C. perfringens .

scholarly journals Virulence Factors and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2020 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Virulence Factors ◽  
Growth Curves ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Infection Model ◽  
Tertiary Teaching ◽  
String Test

Abstract Background: To date, little is known about virulence characteristics of pyogenic liver abscess (PLA) causing multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae). It may be that these strains are rare. The aim of this study was to analyze the virulence characteristics and molecular epidemiology of 12 MDR strains from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes and genotypes.Results: The virulence phenotypes of the 12 PLA-causing MDR K. pneumoniae were similar or even more obvious than those of typical hypervirulent Klebsiella pneumoniae control strains according to the results of growth curves, string test, capsular quantification, serum killing test, biofilm formation assay, and infection model. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. Multilocus sequence typing (MLST) illustrated that the MDR strains were categorized into nine sequence types.Conclusions: This study is the first analysis of the virulence factors in PLA-causing MDR strains. Our data exhibited the coexistence of hypervirulence and multidrug resistance in PLA-causing MDR K. pneumoniae strains, and the clones of those PLA-causing MDR strains were diverse and scattered. The study was firstly found one ST11 carbapenem-resistant hypervirulent strain in PLA.

Endogenous endophthalmitis associated with pyogenic liver abscess caused by Klebsiella pneumoniae: A case report

2021 ◽  
Vol 1 (1) ◽  
pp. 007-009
Author(s):  
Mohamed Hajri ◽  
Souhail Karwiya ◽  
Wael Ferjaoui ◽  
Seifeddine Baccouche ◽  
Sahir Omrani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Exceptional Case ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Percutaneous Transhepatic Drainage ◽  
Transhepatic Drainage

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess" is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

scholarly journals Virulence Characteristics and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2021 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Biofilm Formation ◽  
Growth Curves ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Infection Model ◽  
String Test ◽  
Serum Killing

Abstract Background To date, little is known about the virulence characteristics of pyogenic liver abscess (PLA) that cause multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae), which might be due to the rarity of these strains. This study aimed to analyze the virulence characteristics and molecular epidemiology of 12 MDR strains obtained from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes, and genotypes. Methods The MDR strains were obtained from sterile fluid samples collected from patients with PLA. The antimicrobial susceptibility testing was confirmed by the agar dilution method and microdilution broth method. The virulence phenotypes were analyzed by the growth curves, string test, capsular quantification, serum killing test, biofilm formation assay and infection model. Polymerase chain reaction (PCR) was used to investigate the virulence genotypes. The molecular epidemiology was identified by multilocus sequence typing (MLST). Results The results of growth curves, string test, capsular quantification, serum killing test, biofilm formation assay, and infection model revealed that the virulence phenotypes of the 12 PLA-causing MDR K. pneumoniae were similar to or more obvious than those of the typical hypervirulent K. pneumoniae strains. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. The results of MLST illustrated that the MDR strains were categorized into 9 sequence types. Conclusions This is the first study to analyze the virulence characteristics in PLA-causing MDR strains. The data revealed the coexistence of hypervirulence and MDR in PLA-causing MDR K. pneumoniae strains, and the clones of these strains were diverse and scattered. Also, one ST11 carbapenem-resistant hypervirulent strain was identified in PLA.

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