A Case of Post-pancreaticoduodenectomy Recurrent Liver Abscess Caused by Hypermucoviscous Klebsiella Pneumoniae

Abstract

Invasive liver abscess caused by hypermucoviscous Klebsiella pneumoniae is an infectious disease that can cause metastatic infections and may follow a serious course. We report a case of liver abscess caused by hypermucoviscous K. pneumoniae infection, that required hospitalization and drainage.

A 76-year-old woman underwent pancreatoduodenectomy for pancreatic head cancer. Two weeks after discharge from the hospital, she was admitted for high fever. Computed tomography (CT) revealed a 7-cm liver abscess in segment 3, and percutaneous transhepatic abscess drainage was immediately performed, with continuation of intravenous antibiotic therapy. Once her condition improved, she was discharged. However, 16 days after leaving our hospital for the second time, she was admitted again with high fever. CT revealed relapse of a 4-cm liver abscess in segment 8. We conducted percutaneous transhepatic drainage, and continued antibiotic therapy. As her overall condition was good, the patient was again discharged 25 days after the third hospitalization. After she was discharged from the hospital the third time, she was continued on long-term antibiotic therapy. No relapse of the liver abscess has become apparent since. Culture of the liver abscess revealed infection by hypermucoviscous K. pneumoniae.

Long-term antibiotic therapy is required for the treatment of liver abscess caused by hypermucoviscous K. pneumoniae.