SHM Converge Scientific Abstract ePoster Gallery-Klebsiella Pneumoniae Liver Abscess in a Hispanic Diabetic Male

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This case describes a 40-year-old Hispanic man with poorly controlled diabetes who presented with recurrent high fevers and seizure-like activity, requiring urgent intubation. Initial workup showed encephalopathy and a liver lesion on ultrasound and CT, raising concern for a hepatic abscess. Blood cultures later grew Klebsiella pneumoniae, confirming Klebsiella pneumoniae liver abscess (KPLA).<br /><br />KPLA is classically associated with Southeast Asian populations and diabetes, but it is increasingly recognized in the United States, including among Hispanic patients. The infection often presents with nonspecific symptoms such as fever and may progress rapidly to invasive disease, especially in patients with poor glycemic control. Diabetics are at higher risk for monomicrobial abscesses and metastatic complications involving the brain, eyes, and lungs.<br /><br />In this patient, delayed source control contributed to a severe hospital course complicated by septic shock, disseminated intravascular coagulation, ischemic hepatitis, and acute kidney injury. Planned CT-guided drainage was further complicated by active arterial bleeding, requiring massive transfusion and interventional radiology coil embolization. His antibiotics were ultimately narrowed to ceftriaxone based on susceptibility results.<br /><br />The key message is that KPLA should be considered in any diabetic patient with sepsis and a single liver lesion, even without travel history or classic symptoms. Early recognition, prompt drainage, and appropriate third-generation cephalosporin therapy are critical to preventing life-threatening complications and metastatic spread. Strict glucose control is also important to reduce the risk of severe disease.

Asset Subtitle

Zoheb I. Sulaiman

Meta Tag

Author List Joshuam Ruiz Vega, Mark P. Visitacion, Nathaniel Rodriguez, Zoheb I. Sulaiman

Category Clinical Vignettes

Concept Klebsiella pneumoniae liver abscess

Concept Hepatosplenic Abscess

Concept Diabetes Mellitus

Concept Source Control

Concept Drainage

Distinguished Non-Finalist

Presenter Organization AU/UGA Medical Partnership at St. Mary's Hospital

Presenting Author Zoheb I. Sulaiman

Track Adult

Keywords

Klebsiella pneumoniae liver abscess

KPLA

diabetes

sepsis

hepatic abscess

encephalopathy

septic shock

ceftriaxone

metastatic complications

Hispanic patient

Klebsiella pneumoniae liver abscess

Hepatosplenic Abscess

Diabetes Mellitus

Source Control

Drainage