Klebsiella pneumoniae Infection as a Mimicker of Multiple Metastatic Lesions

Abstract

We describe the case of a 42-year-old man with cirrhosis who presented with fever and imaging concerning for metastatic disease from suspected renal cell carcinoma. He had a right renal mass with multiple pulmonary masses and underwent a lung biopsy and oncology consultation. Blood cultures revealed Klebsiella pneumoniae, and all the lesions disappeared after intravenous (IV) antibiotics. Our case attempts to increase awareness of this unique presentation of invasive Klebsiella infections and discusses host factors that can predispose to this condition.

Keywords: bacterial pyomyositis; klebsiella pneumoniae (kp); metastatic infection; sepsis in liver cirrhosis; septic pulmonary emboli.

Figure 1. CT abdomen and pelvis showing a 4 cm heterogeneously enhancing right renal mass suspicious for renal cell carcinoma.

Figure 2. CT chest showing multiple bilateral pulmonary nodules highly suspicious for metastatic disease, measuring up to 1.5 cm in the right upper lobe.

Figure 3. Resolution of the pulmonary ground glass opacities after IV antibiotics.

IV, intravenous

Figure 4. Resolution of renal abscess after IV antibiotics.

IV, intravenous