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. 2018 Mar 21;5(3):000800.
doi: 10.12890/2018_000800. eCollection 2018.

Klebsiella pneumoniae Invasive Syndrome

Vasco Evangelista  1 , Cristiana V Gonçalves  1 , Raquel Almeida  1 , Célia Henriques  1 , António Martins Baptista  1 , José Pimenta da Graça  1 , José Lomelino Araújo  1
Affiliations

Klebsiella pneumoniae Invasive Syndrome

Vasco Evangelista et al. Eur J Case Rep Intern Med. .

Abstract

Klebsiella pneumoniae invasive syndrome (KPIS) is a rare clinical condition characterized by primary liver abscess associated with metastatic infection. Most case reports are from Southeast Asia, with only one case described in Portugal. The Authors present the case of a 44-year-old man with a history of fever, dry cough and cervicalgia. A thoracic computed tomography (CT) scan showed multiple pulmonary and hepatic nodules, suggestive of metastatic malignancy. Both blood cultures and bronchoalveolar lavage were positive for Klebsiella pneumoniae. Imaging studies were repeated during his hospital stay, showing a reduction in both number and volume of identified lesions, thus revealing their infectious nature. This case illustrates how much this entity can mimic other illnesses.

Learning points: Klebsiella pneumoniae invasive syndrome is emerging as a global disease.The imaging-led diagnosis of neoplasia was proved incorrect and could have been deleterious for the patient.The lack of diagnostic suspicion can lead to shorter antibiotic treatment regimens, therefore compromising the patient's full recovery.

Keywords: Klebsiella pneumoniae; invasive syndrome; liver abscess.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
Thoracic CT: A and B. Multiple pulmonary nodules and nodular condensation with spiculated margins and eccentric cavitation, acknowledged as probable primary tumor
Figure 2
Figure 2
Cervical MRI: findings suggestive of secondary epidural infiltration (arrow)
Figure 3
Figure 3
Abdominal CT: multiple hypodense liver lesions compatible with hepatic abscesses vs secondary necrotizing deposits
Figure 4
Figure 4
Thoracic CT: 4th-week follow-up with unequivocal reduction in both number and volume of nodular pulmonary lesions
See this image and copyright information in PMC

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