Pneumocardia and septic pulmonary embolism due to nongas-forming liver abscess: A case report

Abstract

Rationale: Pneumocardia and septic pulmonary embolism are uncommon complications of Klebsiella pneumoniae primary liver abscess (KPLA); however, they may lead to a poor clinical outcome.

Patient concerns: A 67-year-old woman was admitted to our hospital with fever, chills, cough, and dyspnea for 4 days. She had a previous history of diabetes mellitus.

Diagnoses: The chest computed tomography (CT) revealed multiple peripheral nodules in both lungs and wedge-shaped peripheral infiltrative lesions abutting the pleura, suggestive of septic pulmonary embolism. An abdominal CT on the following day showed a large liver abscess without gas formation and pneumocardia of the right ventricle.

Interventions: After the antibiotic therapy of intravenous imipenem and drainage of the liver abscess, our patient made a complete recovery.

Outcomes: The patient was discharged on the 25th hospital day after full recovery and was doing well on follow-up at 10 months.

Lessons: KPLA is potentially fatal due to the associated serious metastatic complications. Attention must be paid not only to the primary focus of infection but also to infection of other organs. It is important to detect to diagnose the spread of infection accurately, in a timely manner, to improve the prognosis of this condition.

Figure 1

Chest CT showing a wedge-shaped peripheral lesion (arrow, panel A) with feeding vessel sign (arrow, panel A), peripheral nodules (arrow, panel B), and right-sided pleural effusion. Plain and contrast abdominal CT scans showed pneumocardia (arrow, panels C and D), and liver abscess (arrow, panel E). CT = computed tomography.